Performing Systematic Literature Reviews with Novices: An Iterative Approach

Science.gov (United States)

Lavallée, Mathieu; Robillard, Pierre-N.; Mirsalari, Reza

2014-01-01

Reviewers performing systematic literature reviews require understanding of the review process and of the knowledge domain. This paper presents an iterative approach for conducting systematic literature reviews that addresses the problems faced by reviewers who are novices in one or both levels of understanding. This approach is derived from…

A mixed-methods approach to systematic reviews.

Science.gov (United States)

Pearson, Alan; White, Heath; Bath-Hextall, Fiona; Salmond, Susan; Apostolo, Joao; Kirkpatrick, Pamela

2015-09-01

There are an increasing number of published single-method systematic reviews that focus on different types of evidence related to a particular topic. As policy makers and practitioners seek clear directions for decision-making from systematic reviews, it is likely that it will be increasingly difficult for them to identify 'what to do' if they are required to find and understand a plethora of syntheses related to a particular topic.Mixed-methods systematic reviews are designed to address this issue and have the potential to produce systematic reviews of direct relevance to policy makers and practitioners.On the basis of the recommendations of the Joanna Briggs Institute International Mixed Methods Reviews Methodology Group in 2012, the Institute adopted a segregated approach to mixed-methods synthesis as described by Sandelowski et al., which consists of separate syntheses of each component method of the review. Joanna Briggs Institute's mixed-methods synthesis of the findings of the separate syntheses uses a Bayesian approach to translate the findings of the initial quantitative synthesis into qualitative themes and pooling these with the findings of the initial qualitative synthesis.

Advancing Alternative Analysis: Integration of Decision Science.

Science.gov (United States)

Malloy, Timothy F; Zaunbrecher, Virginia M; Batteate, Christina M; Blake, Ann; Carroll, William F; Corbett, Charles J; Hansen, Steffen Foss; Lempert, Robert J; Linkov, Igor; McFadden, Roger; Moran, Kelly D; Olivetti, Elsa; Ostrom, Nancy K; Romero, Michelle; Schoenung, Julie M; Seager, Thomas P; Sinsheimer, Peter; Thayer, Kristina A

2017-06-13

Decision analysis-a systematic approach to solving complex problems-offers tools and frameworks to support decision making that are increasingly being applied to environmental challenges. Alternatives analysis is a method used in regulation and product design to identify, compare, and evaluate the safety and viability of potential substitutes for hazardous chemicals. We assessed whether decision science may assist the alternatives analysis decision maker in comparing alternatives across a range of metrics. A workshop was convened that included representatives from government, academia, business, and civil society and included experts in toxicology, decision science, alternatives assessment, engineering, and law and policy. Participants were divided into two groups and were prompted with targeted questions. Throughout the workshop, the groups periodically came together in plenary sessions to reflect on other groups' findings. We concluded that the further incorporation of decision science into alternatives analysis would advance the ability of companies and regulators to select alternatives to harmful ingredients and would also advance the science of decision analysis. We advance four recommendations: a ) engaging the systematic development and evaluation of decision approaches and tools; b ) using case studies to advance the integration of decision analysis into alternatives analysis; c ) supporting transdisciplinary research; and d ) supporting education and outreach efforts. https://doi.org/10.1289/EHP483.

THE SYSTEMATIC APPROACH TO MANAGEMENT IN EDUCATION

Directory of Open Access Journals (Sweden)

Nikita S. Iskrin

2015-01-01

Full Text Available The purpose of this article is to study the potential of a systematic approach as the basic element of the course content in system training of managers in education. Methods. Methods involve analysis of the theory and practice of application of the system approach to management challenges in education; positions of the general systems’ theory; synergetic approach as «the optimum control mechanism of complex systems»; adaptation of administrative technologies for an education sphere, implemented before and mainly in economy; questioning of educators of an education system of different levels. Results. The authors have proved the necessity of formation of managers’ systems thinking, with the specialization – a variety of educational services rendering. Managerial process characteristics of educational institution are defined. The course as training variant «Education of Managers» is proposed on the basis of the analysis of a historiography and summary results of questioning. Scientific novelty. Theoretical blocks of retraining and reorientation program to new paradigms of educators’ service or activities of are specified. The systematic approach to activity operations management has become the basis of the proposed program. Practical significance. Developed on the basis of results of research and approved course « Systematic approach in educational institution practice: technologies and management issues» helps get over some thinking and the stereotypes that generate the problems in education system development; promotes understanding of management methods in accordance with principles of systematic thinking; realizes and sets the abilities of interrelations revealing between external and internal processes and phenomena in relation to the system; develops an ability to predict the future systems behaviour and readiness to change structure of system, cohesion between its elements and functions.

Training Program Handbook: A systematic approach to training

Energy Technology Data Exchange (ETDEWEB)

1994-08-01

This DOE handbook describes a systematic method for establishing and maintaining training programs that meet the requirements and expectations of DOE Orders 5480.18B and 5480.20. The systematic approach to training includes 5 phases: Analysis, design, development, implementation, and evaluation.

The European Partnership for Alternative Approaches to Animal Testing (EPAA): promoting alternative methods in Europe and beyond.

Science.gov (United States)

Cozigou, Gwenole; Crozier, Jonathan; Hendriksen, Coenraad; Manou, Irene; Ramirez-Hernandez, Tzutzuy; Weissenhorn, Renate

2015-03-01

Here in we introduce the European Partnership for Alternative Approaches to Animal Testing (EPAA) and its activities, which are focused on international cooperation toward alternative methods. The EPAA is one of the leading organizations in Europe for the promotion of alternative approaches to animal testing. Its innovative public-private partnership structure enables a consensus-driven dialogue across 7 industry sectors to facilitate interaction between regulators and regulated stakeholders. Through a brief description of EPAA's activities and organizational structure, we first articulate the value of this collaboration; we then focus on 2 key projects driven by EPAA. The first project aims to address research gaps on stem cells for safety testing, whereas the second project strives for an approach toward demonstration of consistency in vaccine batch release testing. We highlight the growing need for harmonization of international acceptance and implementation of alternative approaches and for increased international collaboration to foster progress on nonanimal alternatives.

Alternative approaches to postgraduate supervision: A planning tool ...

African Journals Online (AJOL)

Increased demands on academics due to the changing work and higher educational environments challenge traditional approaches to postgraduate supervision. Supervisors often tend to follow the apprenticeship approach uncritically. Supervisors therefore need to be aware of alternative approaches to supervision and of ...

A systematic approach to engineering ethics education.

Science.gov (United States)

Li, Jessica; Fu, Shengli

2012-06-01

Engineering ethics education is a complex field characterized by dynamic topics and diverse students, which results in significant challenges for engineering ethics educators. The purpose of this paper is to introduce a systematic approach to determine what to teach and how to teach in an ethics curriculum. This is a topic that has not been adequately addressed in the engineering ethics literature. This systematic approach provides a method to: (1) develop a context-specific engineering ethics curriculum using the Delphi technique, a process-driven research method; and (2) identify appropriate delivery strategies and instructional strategies using an instructional design model. This approach considers the context-specific needs of different engineering disciplines in ethics education and leverages the collaboration of engineering professors, practicing engineers, engineering graduate students, ethics scholars, and instructional design experts. The proposed approach is most suitable for a department, a discipline/field or a professional society. The approach helps to enhance learning outcomes and to facilitate ethics education curriculum development as part of the regular engineering curriculum.

Systematic profiling of alternative splicing signature reveals prognostic predictor for ovarian cancer.

Science.gov (United States)

Zhu, Junyong; Chen, Zuhua; Yong, Lei

2018-02-01

The majority of genes are alternatively spliced and growing evidence suggests that alternative splicing is modified in cancer and is associated with cancer progression. Systematic analysis of alternative splicing signature in ovarian cancer is lacking and greatly needed. We profiled genome-wide alternative splicing events in 408 ovarian serous cystadenocarcinoma (OV) patients in TCGA. Seven types of alternative splicing events were curated and prognostic analyses were performed with predictive models and splicing network built for OV patients. Among 48,049 mRNA splicing events in 10,582 genes, we detected 2,611 alternative splicing events in 2,036 genes which were significant associated with overall survival of OV patients. Exon skip events were the most powerful prognostic factors among the seven types. The area under the curve of the receiver-operator characteristic curve for prognostic predictor, which was built with top significant alternative splicing events, was 0.937 at 2,000 days of overall survival, indicating powerful efficiency in distinguishing patient outcome. Interestingly, splicing correlation network suggested obvious trends in the role of splicing factors in OV. In summary, we built powerful prognostic predictors for OV patients and uncovered interesting splicing networks which could be underlying mechanisms. Copyright © 2017 Elsevier Inc. All rights reserved.

A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome

OpenAIRE

Lauche, Romy;Cramer, Holger;Häuser, Winfried;Dobos, Gustav;Langhorst, Jost

2017-01-01

Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogeth...

Identifying Complementary and Alternative Medicine Usage Information from Internet Resources. A Systematic Review.

Science.gov (United States)

Sharma, Vivekanand; Holmes, John H; Sarkar, Indra N

2016-08-05

Identify and highlight research issues and methods used in studying Complementary and Alternative Medicine (CAM) information needs, access, and exchange over the Internet. A literature search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines from PubMed to identify articles that have studied Internet use in the CAM context. Additional searches were conducted at Nature.com and Google Scholar. The Internet provides a major medium for attaining CAM information and can also serve as an avenue for conducting CAM related surveys. Based on the literature analyzed in this review, there seems to be significant interest in developing methodologies for identifying CAM treatments, including the analysis of search query data and social media platform discussions. Several studies have also underscored the challenges in developing approaches for identifying the reliability of CAM-related information on the Internet, which may not be supported with reliable sources. The overall findings of this review suggest that there are opportunities for developing approaches for making available accurate information and developing ways to restrict the spread and sale of potentially harmful CAM products and information. Advances in Internet research are yet to be used in context of understanding CAM prevalence and perspectives. Such approaches may provide valuable insights into the current trends and needs in context of CAM use and spread.

IDENTIFYING COMPLEMENTARY AND ALTERNATIVE MEDICINE USAGE INFORMATION FROM INTERNET RESOURCES: A SYSTEMATIC REVIEW

Science.gov (United States)

Sharma, V.; Holmes, J.H.; Sarkar, I.N.

2016-01-01

SUMMARY Objective Identify and highlight research issues and methods used in studying Complementary and Alternative Medicine (CAM) information needs, access, and exchange over the Internet. Methods A literature search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines from PubMed to identify articles that have studied Internet use in the CAM context. Additional searches were conducted at Nature.com and Google Scholar. Results The Internet provides a major medium for attaining CAM information and can also serve as an avenue for conducting CAM related surveys. Based on the literature analyzed in this review, there seems to be significant interest in developing methodologies for identifying CAM treatments, including the analysis of search query data and social media platform discussions. Several studies have also underscored the challenges in developing approaches for identifying the reliability of CAM-related information on the Internet, which may not be supported with reliable sources. The overall findings of this review suggest that there are opportunities for developing approaches for making available accurate information and developing ways to restrict the spread and sale of potentially harmful CAM products and information. Conclusions Advances in Internet research are yet to be used in context of understanding CAM prevalence and perspectives. Such approaches may provide valuable insights into the current trends and needs in context of CAM use and spread. PMID:27352304

Introducing linear functions: an alternative statistical approach

Science.gov (United States)

Nolan, Caroline; Herbert, Sandra

2015-12-01

The introduction of linear functions is the turning point where many students decide if mathematics is useful or not. This means the role of parameters and variables in linear functions could be considered to be `threshold concepts'. There is recognition that linear functions can be taught in context through the exploration of linear modelling examples, but this has its limitations. Currently, statistical data is easily attainable, and graphics or computer algebra system (CAS) calculators are common in many classrooms. The use of this technology provides ease of access to different representations of linear functions as well as the ability to fit a least-squares line for real-life data. This means these calculators could support a possible alternative approach to the introduction of linear functions. This study compares the results of an end-of-topic test for two classes of Australian middle secondary students at a regional school to determine if such an alternative approach is feasible. In this study, test questions were grouped by concept and subjected to concept by concept analysis of the means of test results of the two classes. This analysis revealed that the students following the alternative approach demonstrated greater competence with non-standard questions.

An alternative approach for socio-hydrology: case study research

Science.gov (United States)

Mostert, Erik

2018-01-01

Currently the most popular approach in socio hydrology is to develop coupled human-water models. This article proposes an alternative approach, qualitative case study research, involving a systematic review of (1) the human activities affecting the hydrology in the case, (2) the main human actors, and (3) the main factors influencing the actors and their activities. Moreover, this article presents a case study of the Dommel Basin in Belgium and the Netherlands, and compares this with a coupled model of the Kissimmee Basin in Florida. In both basins a pendulum swing from water resources development and control to protection and restoration can be observed. The Dommel case study moreover points to the importance of institutional and financial arrangements, community values, and broader social, economic, and technical developments. These factors are missing from the Kissimmee model. Generally, case studies can result in a more complete understanding of individual cases than coupled models, and if the cases are selected carefully and compared with previous studies, it is possible to generalize on the basis of them. Case studies also offer more levers for management and facilitate interdisciplinary cooperation. Coupled models, on the other hand, can be used to generate possible explanations of past developments and quantitative scenarios for future developments. The article concludes that, given the limited attention they currently get and their potential benefits, case studies deserve more attention in socio-hydrology.

On application of the systematic approach to training in Qinshan NPP

International Nuclear Information System (INIS)

Wang Riqing

1997-01-01

The author describes the feature of systematic approach to training and introduces the situation about using the approach for training operation and maintenance personnel in Qinshan NPP. The final part of paper shows that there are still some problems worthy of serious consideration in application of the systematic approach to training in nuclear power plant

Alternative approaches to providing engineering expertise on shift

International Nuclear Information System (INIS)

Olson, J.; Schreiber, R.E.; Melber, B.D.

1984-05-01

This report represents the conclusions of a project studying the role of engineering expertise on shift in nuclear power plants. Using the present shift technical advisor (STA) position as the base case, several alternatives are analyzed. On-shift alternatives included the STA, the SS (shift supervisor), and the SE (shift engineer). The SE is degreed, experienced, trained, and licensed as a Senior Reactor Operator. Some non-shift alternatives were also studied. These included a cadre of on-call engineers and specialists within continual contact and easy reach of the plant; a technical system of phone and data lines linking the plant with a facility similar to an on-site technical support center; and finally, an SPDS (safety parameter display system) to agument technical upgrading of operator aids presently available. Potential problems considered in the analysis of implementation of these alternatives included job content constraints, problems of crew acceptance, and problems of labor supply and retention. Of the considered alternatives, the SE and SS options appear superior to the current STA approach. The SE approach appears the easiest to implement and the most effective under varied plant conditions. The SE may also serve as liaison to off-site support facilities

A Systematic Approach to Terminal Training.

Science.gov (United States)

Sheffield, John

1980-01-01

Describes the systematic approach used by the training department of the Canada Trust Company to develop a training program for operators of the new terminals for the online banking system to which the bank was converting, the Canadian On-Line Financial Information System (COFIS). (JD)

A Systematic Approach to Programmatic Assessment

Science.gov (United States)

Moffit, Dani M.; Mansell, Jamie L.; Russ, Anne C.

2016-01-01

Context: Accrediting bodies and universities increasingly require evidence of student learning within courses and programs. Within athletic training, programmatic assessment has been a source of angst for program directors. While there are many ways to assess educational programs, this article introduces 1 systematic approach. Objective: This…

Systematic review: Complementary and alternative medicine in the irritable bowel syndrome.

LENUS (Irish Health Repository)

Hussain, Z

2012-02-03

BACKGROUND: Complementary and alternative medical therapies and practices are widely employed in the treatment of the irritable bowel syndrome. AIM: To review the usage of complementary and alternative medicine in the irritable bowel syndrome, and to assess critically the basis and evidence for its use. METHODS: A systematic review of complementary and alternative medical therapies and practices in the irritable bowel syndrome was performed based on literature obtained through a Medline search. RESULTS: A wide variety of complementary and alternative medical practices and therapies are commonly employed by irritable bowel syndrome patients both in conjunction with and in lieu of conventional therapies. As many of these therapies have not been subjected to controlled clinical trials, some, at least, of their efficacy may reflect the high-placebo response rate that is characteristic of irritable bowel syndrome. Of those that have been subjected to clinical trials most have involved small poor quality studies. There is, however, evidence to support efficacy for hypnotherapy, some forms of herbal therapy and certain probiotics in irritable bowel syndrome. CONCLUSIONS: Doctors caring for irritable bowel syndrome patients need to recognize the near ubiquity of complementary and alternative medical use among this population and the basis for its use. All complementary and alternative medicine is not the same and some, such as hypnotherapy, forms of herbal therapy, specific diets and probiotics, may well have efficacy in irritable bowel syndrome. Above all, we need more science and more controlled studies; the absence of truly randomized placebo-controlled trials for many of these therapies has limited meaningful progress in this area.

Reliability analysis - systematic approach based on limited data

International Nuclear Information System (INIS)

Bourne, A.J.

1975-11-01

The initial approaches required for reliability analysis are outlined. These approaches highlight the system boundaries, examine the conditions under which the system is required to operate, and define the overall performance requirements. The discussion is illustrated by a simple example of an automatic protective system for a nuclear reactor. It is then shown how the initial approach leads to a method of defining the system, establishing performance parameters of interest and determining the general form of reliability models to be used. The overall system model and the availability of reliability data at the system level are next examined. An iterative process is then described whereby the reliability model and data requirements are systematically refined at progressively lower hierarchic levels of the system. At each stage, the approach is illustrated with examples from the protective system previously described. The main advantages of the approach put forward are the systematic process of analysis, the concentration of assessment effort in the critical areas and the maximum use of limited reliability data. (author)

Exactly Solvable Quantum Mechanical Potentials: An Alternative Approach.

Science.gov (United States)

Pronchik, Jeremy N.; Williams, Brian W.

2003-01-01

Describes an alternative approach to finding exactly solvable, one-dimensional quantum mechanical potentials. Differs from the usual approach in that instead of starting with a particular potential and seeking solutions to the related Schrodinger equations, it begins with known solutions to second-order ordinary differential equations and seeks to…

A Comparison of Five Alternative Approaches to Information Systems Development

Directory of Open Access Journals (Sweden)

Rudy Hirschheim

1997-11-01

Full Text Available The field of information systems (IS has grown dramatically over the past three decades. Recent trends have transformed the IS landscape. These trends include: the evolution of implementation technology from centralized mainframe environments towards distributed client-server architectures, embracing the internet and intranets; changes in user interface technology from character-based to graphical user interfaces, multimedia, and the World Wide Web; changes in applications from transaction processing systems towards systems supporting collaborative work; and the use of information technology as an enabler of business process reengineering and redesign. These technology changes coupled with changes in organizations and their operating environment, such as the growth of the network and virtual organization, internationalization and globalization of many organizations, intensified global competition, changes in values such as customer orientation (service quality and Quality of Working Life, have imposed new demands on the development of information systems. These changes have led to an increasing discussion about information systems development (ISO, and in particular, the various methods, tools, methodologies, and approaches for ISD. We believe such discussion has opened the door for new, alternative IS development approaches and methodologies. Our paper takes up this theme by describing five alternative ISD approaches, namely the Interactionist approach, the Speech Act-based approach, Soft Systems Methodology, the Trade Unionist approach, and the Professional Work Practices approach. Despite the fact that most of these approaches have a history of over 15 years, their relevance to IS development is not well recognized in the mainstream of IS practice and research, nor is their institutional status comparable to traditional approaches such as structured analysis and design methods. Therefore we characterize the five approaches as 'alternative' in

An Alternative Approach to the Extended Drude Model

Science.gov (United States)

Gantzler, N. J.; Dordevic, S. V.

2018-05-01

The original Drude model, proposed over a hundred years ago, is still used today for the analysis of optical properties of solids. Within this model, both the plasma frequency and quasiparticle scattering rate are constant, which makes the model rather inflexible. In order to circumvent this problem, the so-called extended Drude model was proposed, which allowed for the frequency dependence of both the quasiparticle scattering rate and the effective mass. In this work we will explore an alternative approach to the extended Drude model. Here, one also assumes that the quasiparticle scattering rate is frequency dependent; however, instead of the effective mass, the plasma frequency becomes frequency-dependent. This alternative model is applied to the high Tc superconductor Bi2Sr2CaCu2O8+δ (Bi2212) with Tc = 92 K, and the results are compared and contrasted with the ones obtained from the conventional extended Drude model. The results point to several advantages of this alternative approach to the extended Drude model.

Popular education, alternative pedagogies, and systematization of exp eriences. history and horizons

OpenAIRE

Marcela Gómez Sollano

2015-01-01

In order to think the field of popular education, this article aims to recover some of the historical and conceptual references developed in the program “Pedagogical alternatives and planning education in Latin America” (Known by its Spanish acronym, APPEAL). Likewise, it is analyzed the potential that allows the systematization of in-process and no-documented experiences, as well as the study of the experiences already collected, since they reflect somehow the problem, its dimensions and alt...

Alternative and cost-effective bridge approach slabs.

Science.gov (United States)

2010-10-01

The primary objectives of the proposed project are to investigate the causes for any bumps at the end of the bridge approach slab : and to develop remedial measures or alternative designs for a replacement. It is clear that the problem stems from geo...

[Criteria catalogue to systematize conceptual approaches in universal prevention of childhood overweight : Methodological approach and first results].

Science.gov (United States)

Babitsch, Birgit; Geene, Raimund; Hassel, Holger; Kliche, Thomas; Bacchetta, Britta; Baltes, Simon; Nold, Sandra; Rosenfeldt, Daniel

2016-11-01

Overweight and obesity are serious health risks for children and adolescents. Hence, various prevention projects have been initiated and implemented. Until now, a systematic overview of interventions in different settings has been lacking. The aim of the "Prevention of child overweight" project (SkAP-project) is to prepare a systematic overview of the conceptual approaches used in universal prevention of overweight among children and adolescents. First of all, a comprehensive criteria catalogue will be developed based on systematic searches. In the next step the criteria catalogue will be applied to identify and characterize conceptual approaches. Criteria to describe conceptual approaches as well as determinants of childhood overweight were determined by systematic searches. The searches included relevant data bases and were further expanded by internet and hand search. Three settings (kindergarten, school and communities) and families are addressed by the systematic searches. Additional non-setting specific searches were conducted. A comprehensive criteria catalogue was developed, which allows a detailed analysis of conceptual approaches. This catalogue covers further quality criteria as well as determinants of childhood overweight. Currently, the criteria catalogue is being employed. Although the detailed analysis of conceptual approaches can be regarded as advantage of the criteria catalogue, there are also some limitations, such as the lack of necessary information provided in publications. Overall, the application will reveal an overview regarding universal prevention in childhood overweight, which is still lacking, and will support development in this field.

SEASTAR: systematic evaluation of alternative transcription start sites in RNA.

Science.gov (United States)

Qin, Zhiyi; Stoilov, Peter; Zhang, Xuegong; Xing, Yi

2018-05-04

Alternative first exons diversify the transcriptomes of eukaryotes by producing variants of the 5' Untranslated Regions (5'UTRs) and N-terminal coding sequences. Accurate transcriptome-wide detection of alternative first exons typically requires specialized experimental approaches that are designed to identify the 5' ends of transcripts. We developed a computational pipeline SEASTAR that identifies first exons from RNA-seq data alone then quantifies and compares alternative first exon usage across multiple biological conditions. The exons inferred by SEASTAR coincide with transcription start sites identified directly by CAGE experiments and bear epigenetic hallmarks of active promoters. To determine if differential usage of alternative first exons can yield insights into the mechanism controlling gene expression, we applied SEASTAR to an RNA-seq dataset that tracked the reprogramming of mouse fibroblasts into induced pluripotent stem cells. We observed dynamic temporal changes in the usage of alternative first exons, along with correlated changes in transcription factor expression. Using a combined sequence motif and gene set enrichment analysis we identified N-Myc as a regulator of alternative first exon usage in the pluripotent state. Our results demonstrate that SEASTAR can leverage the available RNA-seq data to gain insights into the control of gene expression and alternative transcript variation in eukaryotic transcriptomes.

Monochorionic twin pregnancies: a systematic approach to ...

African Journals Online (AJOL)

Complications unique to these pregnancies include Twin-To-Twin Transfusion Syndrome (TTTS), Twin Polycythaemia Anaemia Sequence (TAPS), Selective Intrauterine Growth Restriction (sIUGR) and death of the co-twin. Adhering to a systematic and objective approach of management, can lead to early recognition and ...

Governing Academic Medical Center Systems: Evaluating and Choosing Among Alternative Governance Approaches.

Science.gov (United States)

Chari, Ramya; O'Hanlon, Claire; Chen, Peggy; Leuschner, Kristin; Nelson, Christopher

2018-02-01

The ability of academic medical centers (AMCs) to fulfill their triple mission of patient care, medical education, and research is increasingly being threatened by rising financial pressures and resource constraints. Many AMCs are, therefore, looking to expand into academic medical systems, increasing their scale through consolidation or affiliation with other health care systems. As clinical operations grow, though, the need for effective governance becomes even more critical to ensure that the business of patient care does not compromise the rest of the triple mission. Multi-AMC systems, a model in which multiple AMCs are governed by a single body, pose a particular challenge in balancing unity with the needs of component AMCs, and therefore offer lessons for designing AMC governance approaches. This article describes the development and application of a set of criteria to evaluate governance options for one multi-AMC system-the University of California (UC) and its five AMCs. Based on a literature review and key informant interviews, the authors identified criteria for evaluating governance approaches (structures and processes), assessed current governance approaches using the criteria, identified alternative governance options, and assessed each option using the identified criteria. The assessment aided UC in streamlining governance operations to enhance their ability to respond efficiently to change and to act collectively. Although designed for UC and a multi-AMC model, the criteria may provide a systematic way for any AMC to assess the strengths and weaknesses of its governance approaches.

Searching for evidence or approval? A commentary on database search in systematic reviews and alternative information retrieval methodologies.

Science.gov (United States)

Delaney, Aogán; Tamás, Peter A

2018-03-01

Despite recognition that database search alone is inadequate even within the health sciences, it appears that reviewers in fields that have adopted systematic review are choosing to rely primarily, or only, on database search for information retrieval. This commentary reminds readers of factors that call into question the appropriateness of default reliance on database searches particularly as systematic review is adapted for use in new and lower consensus fields. It then discusses alternative methods for information retrieval that require development, formalisation, and evaluation. Our goals are to encourage reviewers to reflect critically and transparently on their choice of information retrieval methods and to encourage investment in research on alternatives. Copyright © 2017 John Wiley & Sons, Ltd.

An alternative approach to modelling HbA1c trajectories in patients with type 2 diabetes mellitus.

Science.gov (United States)

McEwan, Phil; Bennett, Hayley; Qin, Lei; Bergenheim, Klas; Gordon, Jason; Evans, Marc

2017-05-01

Time-dependent HbA1c trajectories in health economic models of type 2 diabetes mellitus (T2DM) are typically informed by the UK Prospective Diabetes Study (UKPDS). However, this approach may not accurately predict HbA1c progression in patients who do not conform to the demographic profile of the original UKPDS cohort. This study aimed to develop an alternative mathematical model (MM) to simulate HbA1c progression in T2DM. A systematic literature review identified studies, published between 2005 and 2015, that reported HbA1c in adult T2DM patients over a minimum duration of 18 months. Pooled data from eligible studies were used to develop an alternative MM equation for HbA1c progression, which was then contrasted with the UKPDS 68 progression equation in illustrative scenarios. A total of 68 studies were eligible for data extraction (mean follow-up time 4.1 years). HbA1c progression was highly heterogeneous across studies, varying with baseline HbA1c, treatment group and patient age. The MM equation was fitted with parameters for mean baseline HbA1c (8.3%), initial change in HbA1c (-0.62%) and upper quartile of maximum observed HbA1c (9.3%). Differences in HbA1c trajectories between the MM and UKPDS approaches altered the timing of therapy escalation in illustrative scenarios. The MM represents an alternative approach to simulate HbA1c trajectories in T2DM models, as UKPDS data may not adequately reflect the heterogeneity of HbA1c profiles observed in clinical studies. However, the choice of approach should ultimately be determined by the characteristics of individual patients under consideration and the clinical face validity of the modelled trajectories. © 2016 John Wiley & Sons Ltd.

A Systematic Approach for Soft Sensor Development

DEFF Research Database (Denmark)

Lin, Bao; Recke, Bodil; Renaudat, Philippe

2007-01-01

This paper presents a systematic approach based on robust statistical techniques for development of a data-driven soft sensor, which is an important component of the process analytical technology (PAT) and is essential for effective quality control. The data quality is obviously of essential...... significance for a data-driven soft sensor. Therefore, preprocessing procedures for process measurements are described in detail. First, a template is defined based on one or more key process variables to handle missing data related to severe operation interruptions. Second, a univariate, followed...... reveal the effectiveness of the systematic framework in deriving data-driven soft sensors that provide reasonably reliable one-step-ahead predictions....

Prevalence of Complementary and Alternative Medicine Use among U.S. College Students: A Systematic Review

Science.gov (United States)

Nowak, Amy L. Versnik; Hale, Heidi M.

2012-01-01

Research shows that Americans are using increasing amounts of complementary and alternative medicine (CAM) and that education is a significant predictor of CAM use. The purpose of this systematic review is to summarize key research findings on CAM use rates among U.S. college students and recommend future actions for researchers and health…

Alternative perturbation approaches in classical mechanics

International Nuclear Information System (INIS)

Amore, Paolo; Raya, Alfredo; Fernandez, Francisco M

2005-01-01

We discuss two alternative methods, based on the Lindstedt-Poincare technique, for the removal of secular terms from the equations of perturbation theory. We calculate the period of an anharmonic oscillator by means of both approaches and show that one of them is more accurate for all values of the coupling constant. We believe that present discussion and comparison may be a suitable exercise for teaching perturbation theory in advanced undergraduate courses on classical mechanics

Augmentative and alternative communication in children with Down's syndrome: a systematic review.

Science.gov (United States)

Barbosa, Renata Thaís de Almeida; de Oliveira, Acary Souza Bulle; de Lima Antão, Jennifer Yohanna Ferreira; Crocetta, Tânia Brusque; Guarnieri, Regiani; Antunes, Thaiany Pedrozo Campos; Arab, Claudia; Massetti, Thaís; Bezerra, Italla Maria Pinheiro; de Mello Monteiro, Carlos Bandeira; de Abreu, Luiz Carlos

2018-05-11

The use of technology to assist in the communication, socialization, language, and motor skills of children with Down's syndrome (DS) is required. The aim of this study was to analyse research findings regarding the different instruments of 'augmentative and alternative communication' used in children with Down's syndrome. This is a systematic review of published articles available on PubMed, Web of Science, PsycInfo, and BVS using the following descriptors: assistive technology AND syndrome, assistive technology AND down syndrome, down syndrome AND augmentative and alternative communication. Studies published in English were selected if they met the following inclusion criteria: (1) study of children with a diagnosis of DS, and (2) assistive technology and/or augmentative and alternative communication analysis in this population. A total of 1087 articles were identified. Thirteen articles met the inclusion criteria. The instruments most used by the studies were speech-generating devices (SGDs) and the Picture Exchange Communication System (PECS). Twelve instruments that provided significant aid to the process of communication and socialization of children with DS were identified. These instruments increase the interaction between individuals among this population and their peers, contributing to their quality of life and self-esteem.

Alternative approaches to risk-based technical specifications

International Nuclear Information System (INIS)

Atefi, B.; Gallagher, D.W.; Liner, R.T.; Lofgren, E.V.

1987-01-01

Four alternative risk-based approaches to Technical Specifications are identified. These are: a Probabilistic Risk Assessment (PRA) oriented approach; a reliability goal-oriented approach; an approach based on configuration control; a data-oriented approach. Based on preliminary results, the PRA-oriented approach, which has been developed further than the other approaches, seems to offer a logical, quantitative basis for setting Allowed Outage Times (AOTs) and Surveillance Test Intervals (STIs) for some plant components and systems. The most attractive feature of this approach is that it directly links the AOTs and STIs with the risk associated with the operation of the plant. This would focus the plant operator's and the regulatory agency's attention on the most risk-significant components of the plant. A series of practical issues related to the level of detail and content of the plant PRAs, requirements for the review of these PRAs, and monitoring cf the plant's performance by the regulatory agency must be resolved before the approach could be implemented. Future efforts will examine the other three approaches and their practicality before firm conclusions are drawn regarding the viability of any of these approaches

A systematic approach for the location of hand sanitizer dispensers in hospitals.

Science.gov (United States)

Cure, Laila; Van Enk, Richard; Tiong, Ewing

2014-09-01

Compliance with hand hygiene practices is directly affected by the accessibility and availability of cleaning agents. Nevertheless, the decision of where to locate these dispensers is often not explicitly or fully addressed in the literature. In this paper, we study the problem of selecting the locations to install alcohol-based hand sanitizer dispensers throughout a hospital unit as an indirect approach to maximize compliance with hand hygiene practices. We investigate the relevant criteria in selecting dispenser locations that promote hand hygiene compliance, propose metrics for the evaluation of various location configurations, and formulate a dispenser location optimization model that systematically incorporates such criteria. A complete methodology to collect data and obtain the model parameters is described. We illustrate the proposed approach using data from a general care unit at a collaborating hospital. A cost analysis was performed to study the trade-offs between usability and cost. The proposed methodology can help in evaluating the current location configuration, determining the need for change, and establishing the best possible configuration. It can be adapted to incorporate alternative metrics, tailored to different institutions and updated as needed with new internal policies or safety regulation.

Estimating productivity costs using the friction cost approach in practice: a systematic review.

Science.gov (United States)

Kigozi, Jesse; Jowett, Sue; Lewis, Martyn; Barton, Pelham; Coast, Joanna

2016-01-01

The choice of the most appropriate approach to valuing productivity loss has received much debate in the literature. The friction cost approach has been proposed as a more appropriate alternative to the human capital approach when valuing productivity loss, although its application remains limited. This study reviews application of the friction cost approach in health economic studies and examines how its use varies in practice across different country settings. A systematic review was performed to identify economic evaluation studies that have estimated productivity costs using the friction cost approach and published in English from 1996 to 2013. A standard template was developed and used to extract information from studies meeting the inclusion criteria. The search yielded 46 studies from 12 countries. Of these, 28 were from the Netherlands. Thirty-five studies reported the length of friction period used, with only 16 stating explicitly the source of the friction period. Nine studies reported the elasticity correction factor used. The reported friction cost approach methods used to derive productivity costs varied in quality across studies from different countries. Few health economic studies have estimated productivity costs using the friction cost approach. The estimation and reporting of productivity costs using this method appears to differ in quality by country. The review reveals gaps and lack of clarity in reporting of methods for friction cost evaluation. Generating reporting guidelines and country-specific parameters for the friction cost approach is recommended if increased application and accuracy of the method is to be realized.

Money and Growth: An Alternative Approach.

OpenAIRE

Ireland, Peter N

1994-01-01

This paper takes an alternative approach to the topic of money and growth by developing a model in which the effects of sustained capital accumulation on an evolving system of payments, in addition to the conventional effects of sustained inflation on growth, are examined. While the effects of inflation on growth are small, the effects of growth on the monetary system are substantial. The results are consistent with ideas about money and growth contained in work that predates that of James To...

Approaches that use software to support the prevention of pressure ulcer: A systematic review.

Science.gov (United States)

Marchione, F G; Araújo, L M Q; Araújo, L V

2015-10-01

The incidence and costs for pressure ulcer (PU) treatment remain high even though preventive methods are applied. Approaches that use software to support the prevention of PU are presented in the literature to make it more effective. Identify the state of art of the approaches that use software to support the prevention of PUs. A systematic literature review was performed to analyze approaches that use software to support the prevention of PU. ACM, IEEE, PubMed, Scopus, CINAHL and Embase databases have been searched with a predetermined search string to identify primary studies. We selected the ones that met the established inclusion criteria. Thirty-six articles met the inclusion criteria. To support prevention, most approaches monitor the patient to provide information about exposure to pressure, temperature level, humidity level and estimated body position in bed providing risk factor intensity charts and intensity maps. The main method to perform patient's monitoring is using sensors installed on the mattress, but recently, alternative methods have been proposed such as electronic sensors and tactile sensory coils. Part of the approaches performs automated management of the risk factors using ventilation tubes and mattresses with porous cells to decrease body's temperature and movable cells to automatically redistribute the pressure over the body. Matters as cost of the approach, patient comfort and hygiene of the monitoring equipment is only briefly discussed in the selected articles. No experiments have been conducted to evidence the approached may reduce PU incidence. Currently, approaches that use software to support the prevention of PU provide relevant information to health professionals such as risk factor intensity charts and intensity maps. Some of them can even automatically manage risk factors in a limited way. Yet, the approaches are based on risk factor monitoring methods that require patient's contact with the monitoring equipment. Therefore, some

AN ALTERNATIVE APPROACH TO THE USE OF HEAVY OIL RESIDUE

Directory of Open Access Journals (Sweden)

Eugene Dashut

2013-01-01

Full Text Available We consider an alternative approach to the existing oil refining, in which instead of a single priority that emerged in the traditional approach, we consider two: get the light component and a heavy residue used for the production of new construction materials.

A Systematic Approach for Engagement Analysis Under Multitasking Environments

Science.gov (United States)

Zhang, Guangfan; Leddo, John; Xu, Roger; Richey, Carl; Schnell, Tom; McKenzie, Frederick; Li, Jiang

2011-01-01

An overload condition can lead to high stress for an operator and further cause substantial drops in performance. On the other extreme, in automated systems, an operator may become underloaded; in which case, it is difficult for the operator to maintain sustained attention. When an unexpected event occurs, either internal or external to the automated system, a disengaged operation may neglect, misunderstand, or respond slowly/inappropriately to the situation. In this paper, we discuss a systematic approach monitor for extremes of cognitive workload and engagement in multitasking environments. Inferences of cognitive workload ar engagement are based on subjective evaluations, objective performance measures, physiological signals, and task analysis results. The systematic approach developed In this paper aggregates these types of information collected under the multitasking environment and can provide a real-time assessment or engagement.

The value of postmortem computed tomography as an alternative for autopsy in trauma victims: a systematic review

NARCIS (Netherlands)

Scholing, M.; Saltzherr, T. P.; Fung Kon Jin, P. H. P.; Ponsen, K. J.; Reitsma, J. B.; Lameris, J. S.; Goslings, J. C.

2009-01-01

The aim of this study was to assess the role of postmortem computed tomography (PMCT) as an alternative for autopsy in determining the cause of death and the identification of specific injuries in trauma victims. A systematic review was performed by searching the EMBASE and MEDLINE databases.

An alternative approach to absolute-value test for the parameters of ...

African Journals Online (AJOL)

An alternative approach to absolute-value test statistic Mn is developed for conducting tests simultaneously on all the parameters of multiple linear regression models. Under certain null and alternative hypotheses, the new test statistic is shown to have limiting central and noncentral chisquare distributions, respectively.

Integrative therapies for low back pain that include complementary and alternative medicine care: a systematic review.

Science.gov (United States)

Kizhakkeveettil, Anupama; Rose, Kevin; Kadar, Gena E

2014-09-01

Systematic review of the literature. To evaluate whether an integrated approach that includes different Complementary and Alternative Medicine (CAM) therapies combined or CAM therapies combined with conventional medical care is more effective for the management of low back pain (LBP) than single modalities alone. LBP is one of the leading causes of disability worldwide, yet its optimal management is still unresolved. The PRISMA Statement guidelines were followed. The Cochrane Back Review Group scale was used to rate the quality of the studies found. Twenty-one studies were found that met the inclusion criteria. The CAM modalities used in the studies included spinal manipulative therapy, acupuncture, exercise therapy, physiotherapy, massage therapy, and a topical ointment. Twenty studies included acupuncture and/or spinal manipulative therapy. Nine high quality studies showed that integrative care was clinically effective for the management of LBP. Spinal manipulative therapy combined with exercise therapy and acupuncture combined with conventional medical care or with exercise therapy appears to be promising approaches to the management of chronic cases of LBP. There is support in the literature for integrated CAM and conventional medical therapy for the management of chronic LBP. Further research into the integrated management of LBP is clearly needed to provide better guidance for patients and clinicians.

Application of systematic approach to training at TVO Nuclear Power Plant

International Nuclear Information System (INIS)

Piirto, A.; Latva, T.-M.; Yli-Antola, K.

2002-01-01

Systematic Approach to Training has been used at TVO as the basic principle directing training activity especially in the training of operating personnel. This paper presents how training in general has been planned to be developed. Special attention has been paid on the more systematic realization of the training program of maintenance personnel

Complementary and alternative medicine for lowering blood lipid levels: A systematic review of systematic reviews.

Science.gov (United States)

Posadzki, Paul; AlBedah, Abdullah M N; Khalil, Mohamed M K; AlQaed, Meshari S

2016-12-01

The aim of this article is to summarize and critically evaluate the evidence from systematic reviews (SRs) of complementary and alternative medicine (CAM) for lowering blood lipid levels (BLL). Eight electronic databases were searched until March 2016. Additionally, all the retrieved references were inspected manually for further relevant papers. Systematic reviews were considered eligible, if they included patients of any age and/or gender with elevated blood lipid levels using any type of CAM. We used the Oxman and AMSTAR criteria to critically appraise the methodological quality of the included SRs. Twenty-seven SRs were included in the analyses. The majority of the SRs were of high methodological quality (mean Oxman score=4.81, SD=4.88; and the mean AMSTAR score=7.22, SD=3.38). The majority of SRs (56%) arrived at equivocal conclusions (of these 8 were of high quality); 7 SRs (37%) arrived at positive conclusions (of these 6 were of high quality), and 2 (7%) arrived at negative conclusions (both were of high quality). There was conflicting evidence regarding the effectiveness of garlic; and promising evidence for yoga. To conclude, the evidence from SRs evaluating the effectiveness of CAM in lowering BLL is predominantly equivocal and confusing. Several limitations exist, such as variety of doses and preparations, confounding effects of diets and lifestyle factors, or heterogeneity of the primary trials among others. Copyright © 2016. Published by Elsevier Ltd.

Bone marrow lesions: A systematic diagnostic approach

International Nuclear Information System (INIS)

Grande, Filippo Del; Farahani, Sahar J; Carrino, John A; Chhabra, Avneesh

2014-01-01

Bone marrow lesions on magnetic resonance (MR) imaging are common and may be seen with various pathologies. The authors outline a systematic diagnostic approach with proposed categorization of various etiologies of bone marrow lesions. Utilization of typical imaging features on conventional MR imaging techniques and other problem-solving techniques, such as chemical shift imaging and diffusion-weighted imaging (DWI), to achieve accurate final diagnosis has been highlighted

Propensity Score Analysis: An Alternative Statistical Approach for HRD Researchers

Science.gov (United States)

Keiffer, Greggory L.; Lane, Forrest C.

2016-01-01

Purpose: This paper aims to introduce matching in propensity score analysis (PSA) as an alternative statistical approach for researchers looking to make causal inferences using intact groups. Design/methodology/approach: An illustrative example demonstrated the varying results of analysis of variance, analysis of covariance and PSA on a heuristic…

Advancing practice relating to SEA alternatives

International Nuclear Information System (INIS)

González, Ainhoa; Thérivel, Riki; Fry, John; Foley, Walter

2015-01-01

Developing and assessing alternatives is a key and central stage to Strategic Environmental Assessment (SEA). However, research has repeatedly reported this stage as one of the most poorly undertaken aspects of the SEA process. Current practice limitations include belated consideration of reasonable alternatives, narrow scope of alternatives that often include unrealistic or retrofitted options, limited stakeholder and public involvement in their identification, assessment and selection, lack of systematic approaches to their assessment and comparison, and inadequate reporting of the ‘storyline’ on how they were identified, what the potential impacts are and why the preferred alternative was selected. These issues have resulted in objections and judicial reviews. On the positive side, a number of good practice case studies enable extraction of key lessons and formulation of a set of general recommendations to advance practice in SEA alternatives. In this paper, practical guidance on the identification and development of alternatives, their assessment and comparison, selection of the preferred option, and documentation of the process and the reasons for selection is provided and discussed to frame good practice approaches. - Highlights: • Alternatives are one of the most poorly completed aspects of Strategic Environmental Assessment. • Current practice limitations need to be addressed to enhance SEA effectiveness. • A set of recommendations are extracted from good practice case studies. • These recommendations can be applied across jurisdictions and sectors and tailored as necessary

Advancing practice relating to SEA alternatives

Energy Technology Data Exchange (ETDEWEB)

González, Ainhoa, E-mail: agonzal@tcd.ie [School of Natural Sciences, Trinity College Dublin, Dublin 2 (Ireland); Thérivel, Riki, E-mail: levett-therivel@phonecoop.coop [Levett-Therivel Sustainability Consultants (United Kingdom); Fry, John, E-mail: john.fry@ucd.ie [School of Agriculture and Food Science, University College Dublin, Dublin 4 (Ireland); Foley, Walter, E-mail: walterfoley@gmail.com [School of Geography, Planning and Environmental Policy, University College Dublin, Dublin 4 (Ireland)

2015-07-15

Developing and assessing alternatives is a key and central stage to Strategic Environmental Assessment (SEA). However, research has repeatedly reported this stage as one of the most poorly undertaken aspects of the SEA process. Current practice limitations include belated consideration of reasonable alternatives, narrow scope of alternatives that often include unrealistic or retrofitted options, limited stakeholder and public involvement in their identification, assessment and selection, lack of systematic approaches to their assessment and comparison, and inadequate reporting of the ‘storyline’ on how they were identified, what the potential impacts are and why the preferred alternative was selected. These issues have resulted in objections and judicial reviews. On the positive side, a number of good practice case studies enable extraction of key lessons and formulation of a set of general recommendations to advance practice in SEA alternatives. In this paper, practical guidance on the identification and development of alternatives, their assessment and comparison, selection of the preferred option, and documentation of the process and the reasons for selection is provided and discussed to frame good practice approaches. - Highlights: • Alternatives are one of the most poorly completed aspects of Strategic Environmental Assessment. • Current practice limitations need to be addressed to enhance SEA effectiveness. • A set of recommendations are extracted from good practice case studies. • These recommendations can be applied across jurisdictions and sectors and tailored as necessary.

Measurement Properties of Questionnaires Assessing Complementary and Alternative Medicine Use in Pediatrics: A Systematic Review

Science.gov (United States)

Toupin April, Karine; Moher, David; Stinson, Jennifer; Byrne, Ani; White, Meghan; Boon, Heather; Duffy, Ciarán M.; Rader, Tamara; Vohra, Sunita; Tugwell, Peter

2012-01-01

Objective Complementary and alternative medicine (CAM) is commonly used by children, but estimates of that use vary widely partly due to the range of questionnaires used to assess CAM use. However, no studies have attempted to appraise measurement properties of these questionnaires. The aim of this systematic review was to critically appraise and summarize measurement properties of questionnaires of CAM use in pediatrics. Study design A search strategy was implemented in major electronic databases in March 2011 and conference websites, scientific journals and experts were consulted. Studies were included if they mentioned a questionnaire assessing the prevalence of CAM use in pediatrics. Members of the team independently rated the methodological quality of the studies (using the COSMIN checklist) and measurement properties of the questionnaires (using the Terwee and Cohen criteria). Results A total of 96 CAM questionnaires were found in 104 publications. The COSMIN checklist showed that no studies reported adequate methodological quality. The Terwee criteria showed that all included CAM questionnaires had indeterminate measurement properties. According to the Cohen score, none were considered to be a well-established assessment, two approached the level of a well-established assessment, seven were promising assessments and the remainder (n = 87) did not reach the score’s minimum standards. Conclusion None of the identified CAM questionnaires have been thoroughly validated. This systematic review highlights the need for proper validation of CAM questionnaires in pediatrics, which may in turn lead to improved research and knowledge translation about CAM in clinical practice. PMID:22768098

An approach to evaluating alternatives for wind power plant locations

Directory of Open Access Journals (Sweden)

Rehman, Ateekh Ur

2016-12-01

Full Text Available Multi-criteria decision approaches are preferred for achieving multi-dimensional sustainable renewable energy goals. A more critical issue faced by the wind power industry is the selection of a location to tap prospective energy, which needs to be evaluated on multiple measures. In this paper, the aim is to assess and rank alternative wind power plant locations in Saudi Arabia. The approach presented here takes multiple criteria into consideration, such as wind speed, wind availability, site advantages, terrain details, risk and uncertainty, technology used, third party support, projected demand, types of customers, and government policies. A comparative analysis of feasible alternatives that satisfy all multi- criteria objectives is carried out. The results obtained are subjected to sensitivity analysis. Concepts such as ‘threshold values’ and ‘attribute weights’ make the approach more sensitive.

Systematic approach for synthesis of palm oil-based biorefinery

Energy Technology Data Exchange (ETDEWEB)

NG, Rex T. L.; NG, Denny K. S.; LAM, Hon Loong [Dept. of Chemical and Environmental Engineering, Centre of Excellence for Green Technologies, Univ. of Nottingham, Selangor, (Malaysia); TAY, Douglas H. S.; LIM, Joseph H. E. [2GGS Eco Solutions Sdn Bhd, Kuala Lumpur (Malaysia)

2012-11-01

Various types of palm oil biomasses are generated from palm oil mill when crude palm oil (CPO) is produced from fresh fruit bunch (FFB). In the current practice, palm oil biomasses are used as the main source of energy input in the palm oil mill to produce steam and electricity. Moreover, those biomasses are regarded as by-products and can be reclaimed easily. Therefore, there is a continuous increasing interest concerning biomasses generated from the palm oil mill as a source of renewable energy. Although various technologies have been exploited to produce bio-fuel (i.e., briquette, pellet, etc.) as well as heat and power generation, however, no systematic approach which can analyse and optimise the synthesise biorefinery is presented. In this work, a systematic approach for synthesis and optimisation of palm oil-based biorefinery which including palm oil mill and refinery with maximum economic performance is developed. The optimised network configuration with achieves the maximum economic performance can also be determined. To illustrate the proposed approach, a case study is solved in this work.

Systematic review of complementary and alternative medicine treatments in inflammatory bowel diseases.

Science.gov (United States)

Langhorst, J; Wulfert, H; Lauche, R; Klose, P; Cramer, H; Dobos, G J; Korzenik, J

2015-01-01

We performed a systematic review for Complementary and Alternative Medicine [CAM] as defined by the National Institute of Health in Inflammatory Bowel Disease [IBD], ie Crohn's disease [CD] and ulcerative colitis [UC], with the exception of dietary and nutritional supplements, and manipulative therapies. A computerized search of databases [Cochrane Library, Pubmed/Medline, PsychINFO, and Scopus] through March 2014 was performed. We screened the reference sections of original studies and systematic reviews in English language for CAM in IBD, CD and UC. Randomized controlled trials [RCT] and controlled trials [CT] were referred and assessed using the Cochrane risk of bias tool. A total of: 26 RCT and 3 CT for herbal medicine, eg aloe-vera gel, andrographis paniculata, artemisia absinthium, barley foodstuff, boswellia serrata, cannabis, curcumin, evening primrose oil, Myrrhinil intest®, plantago ovata, silymarin, sophora, tormentil, wheatgrass-juice and wormwood; 1 RCT for trichuris suis ovata; 7 RCT for mind/body interventions such as lifestyle modification, hypnotherapy, relaxation training and mindfulness; and 2 RCT in acupuncture; were found. Risk of bias was quite heterogeneous. Best evidence was found for herbal therapy, ie plantago ovata and curcumin in UC maintenance therapy, wormwood in CD, mind/body therapy and self-intervention in UC, and acupuncture in UC and CD. Complementary and alternative therapies might be effective for the treatment of inflammatory bowel diseases; however, given the low number of trials and the heterogeneous methodological quality of trials, further in-depth research is necessary. Copyright © 2014 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Cost-effectiveness evaluation of alternatives in environmental impact statements

International Nuclear Information System (INIS)

Weiser, A.L.

1977-01-01

Although it has been Federal government officials who have been accused in courts of law with mismanagement with regard to the consideration of alternatives in the environmental impact statement, the responsibility for systematically considering all alternatives to a proposed project remains with project decisionmakers in the Federal, state, or local levels of government and in industry. By applying the techniques of system cost-effectiveness analysis to the assessment of alternatives, it is believed that management will be able to clearly demonstrate that the selection of the proposed approach was neither arbitrary nor capricious. A rational approach to the assessment of alternatives should aid in meeting the mandates of environmental legislation and EIS guidelines, and it should eliminate the merit of any plaintiff's charge of mismanagement with regard to management's consideration of alternatives. Even though many interfaces between the proposed system and the environment cannot as yet be objectively quantified, application of CE techniques will demonstrate that a rigorous exploration and objective evaluation has been applied to the consideration of alternatives with respect to project objectives, financial conditions, and adverse environmental impacts

Bone marrow lesions: A systematic diagnostic approach

Directory of Open Access Journals (Sweden)

Filippo Del Grande

2014-01-01

Full Text Available Bone marrow lesions on magnetic resonance (MR imaging are common and may be seen with various pathologies. The authors outline a systematic diagnostic approach with proposed categorization of various etiologies of bone marrow lesions. Utilization of typical imaging features on conventional MR imaging techniques and other problem-solving techniques, such as chemical shift imaging and diffusion-weighted imaging (DWI, to achieve accurate final diagnosis has been highlighted.

An alternative approach for teacher education framed by a collaborative partnership setting

DEFF Research Database (Denmark)

Pontoppidan, Birgitte Schou

The study presents an alternative didactical approach to teacher education linking practice and theory through a collaborative partnership setting. Using a ―small scale teaching design in which students alternate between schools and college it was possible to show someevidence that, by following...... this approach, first year student teachers in a science & technology class developed teacher knowledge (as aspects of PCK). The study identifies an example using Co-Re and PaPeR as a Resource Folio to show where evidence of developing teacher knowledge is seen. This didactical approach turns the traditional...... teacher education on its head and begins with a focus on practice so students alternate between school–based and college–based teaching in a cyclical fashion, and are encouraged to link theory with practice. This kind of college teaching demands a new teacher educational paradigm for which collaboration...

AN ALTERNATIVE APPROACH FOR TEACHER EDUCATION COURSES FRAMED BY A COLLABORATE PARTNERSHIP

DEFF Research Database (Denmark)

Pontoppidan, Birgitte

2010-01-01

The study presents an alternative didactical approach to teacher education linking practice and theory through a collaborative partnership setting. Using a “small scale” teaching design in which students alternate between schools and college it was possible to show some evidence that, by following...... this approach, first year student teachers in a science & technology class developed teacher knowledge (as aspects of PCK). The study identifies an example using Co-Re and PaPeR as a Resource Folio to show where evidence of developing teacher knowledge is seen. This didactical approach turns the traditional...... teacher education on its head and begins with a focus on practice so students alternate between school–based and college–based teaching in a cyclical fashion, and are encouraged to link theory with practice. This kind of college teaching demands a new teacher educational paradigm for which collaboration...

Alternative approaches for identifying acute systemic toxicity: Moving from research to regulatory testing.

Science.gov (United States)

Hamm, Jon; Sullivan, Kristie; Clippinger, Amy J; Strickland, Judy; Bell, Shannon; Bhhatarai, Barun; Blaauboer, Bas; Casey, Warren; Dorman, David; Forsby, Anna; Garcia-Reyero, Natàlia; Gehen, Sean; Graepel, Rabea; Hotchkiss, Jon; Lowit, Anna; Matheson, Joanna; Reaves, Elissa; Scarano, Louis; Sprankle, Catherine; Tunkel, Jay; Wilson, Dan; Xia, Menghang; Zhu, Hao; Allen, David

2017-06-01

Acute systemic toxicity testing provides the basis for hazard labeling and risk management of chemicals. A number of international efforts have been directed at identifying non-animal alternatives for in vivo acute systemic toxicity tests. A September 2015 workshop, Alternative Approaches for Identifying Acute Systemic Toxicity: Moving from Research to Regulatory Testing, reviewed the state-of-the-science of non-animal alternatives for this testing and explored ways to facilitate implementation of alternatives. Workshop attendees included representatives from international regulatory agencies, academia, nongovernmental organizations, and industry. Resources identified as necessary for meaningful progress in implementing alternatives included compiling and making available high-quality reference data, training on use and interpretation of in vitro and in silico approaches, and global harmonization of testing requirements. Attendees particularly noted the need to characterize variability in reference data to evaluate new approaches. They also noted the importance of understanding the mechanisms of acute toxicity, which could be facilitated by the development of adverse outcome pathways. Workshop breakout groups explored different approaches to reducing or replacing animal use for acute toxicity testing, with each group crafting a roadmap and strategy to accomplish near-term progress. The workshop steering committee has organized efforts to implement the recommendations of the workshop participants. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pharmacological interventions to treat phlebitis: systematic review.

Science.gov (United States)

dos Reis, Paula Elaine Diniz; Silveira, Renata Cristina de Campos Pereira; Vasques, Christiane Inocêncio; de Carvalho, Emilia Campos

2009-01-01

This study presents a systematic review for evaluating effective pharmacological actions for the treatment of phlebitis stemming from infusion therapy. The studies reviewed were categorized according to the type of therapeutic approach proposed by the author and by the level of evidence presented. The review found that topical nitroglycerin and notoginseny were more effective in the reduction of the inflammatory process when compared with other proposed alternatives. Nevertheless, the development of research related to possible alternatives for the treatment of phlebitis is important.

A model-data based systems approach to process intensification

DEFF Research Database (Denmark)

Gani, Rafiqul

. Their developments, however, are largely due to experiment based trial and error approaches and while they do not require validation, they can be time consuming and resource intensive. Also, one may ask, can a truly new intensified unit operation be obtained in this way? An alternative two-stage approach is to apply...... a model-based synthesis method to systematically generate and evaluate alternatives in the first stage and an experiment-model based validation in the second stage. In this way, the search for alternatives is done very quickly, reliably and systematically over a wide range, while resources are preserved...... for focused validation of only the promising candidates in the second-stage. This approach, however, would be limited to intensification based on “known” unit operations, unless the PI process synthesis/design is considered at a lower level of aggregation, namely the phenomena level. That is, the model-based...

Predicting the carcinogenicity of chemicals with alternative approaches: recent advances.

Science.gov (United States)

Benigni, Romualdo

2014-09-01

Alternative approaches to the rodent bioassay are necessary for early identification of problematic drugs and biocides during the development process, and are the only practicable tool for assessing environmental chemicals with no or adequate safety documentation. This review informs on: i) the traditional prescreening through genotoxicity testing; ii) an integrative approach that assesses DNA-reactivity and ability to disorganize tissues; iii) new applications of omics technologies (ToxCast/Tox21 project); iv) a pragmatic approach aimed at filling data gaps by intrapolating/extrapolating from similar chemicals (read-across, category formation). The review also approaches the issue of the concerns about false-positive and false-negative results that prevents a wider acceptance and use of alternatives. The review addresses strengths and limitations of various proposals, and concludes on the need of differential approaches to the issue of false negatives and false positives. False negatives can be eliminated or reduced below the variability of the animal assay with conservative quantitative structure-activity relationships or in vitro tests; false positives can be cleared with ad hoc mechanistically based follow-ups. This framework can permit a reduction of animal testing and a better protection of human health.

A systematic approach for designing a HBM Pilot Study for Europe

DEFF Research Database (Denmark)

Becker, Kerstin; Seiwert, Margarete; Casteleyn, Ludwine

2014-01-01

of a human biomonitoring study. Furthermore, it provides an example for a systematic approach that may be useful to other research groups or pan-European research initiatives. In the study protocol that will be published elsewhere these aspects are elaborated and additional aspects are covered (Casteleyn et...... biomonitoring (HBM) study and for the implementation of the fieldwork procedures. The approach gave the basis for discussion of the main aspects of study design and conduct, and provided a decision making tool which can be applied to many other studies. Each decision that had to be taken was listed in a table......The objective of COPHES (Consortium to Perform Human biomonitoring on a European Scale) was to develop a harmonised approach to conduct human biomonitoring on a European scale. COPHES developed a systematic approach for designing and conducting a pilot study for an EU-wide cross-sectional human...

Systematic Approach to Research Training: Benefits for Counseling Practice.

Science.gov (United States)

Loughead, Teri A.; And Others

1991-01-01

Synthesizes developments concerning research training in graduate counselor education and presents a systematic approach for training master's and doctoral students in mental health counseling to assimilate, use, and perform research. Suggests diversity of research training strategies for implementation in counselor preparation programs.…

Complementary and Alternative Medicine for Management of Premature Ejaculation: A Systematic Review.

Science.gov (United States)

Cooper, Katy; Martyn-St James, Marrissa; Kaltenthaler, Eva; Dickinson, Kath; Cantrell, Anna; Ren, Shijie; Wylie, Kevan; Frodsham, Leila; Hood, Catherine

2017-03-01

Premature ejaculation (PE) is defined as ejaculation within 1 minute (lifelong PE) or 3 minutes (acquired PE), inability to delay ejaculation, and negative personal consequences. Management includes behavioral and pharmacologic approaches. To systematically review effectiveness, safety, and robustness of evidence for complementary and alternative medicine in managing PE. Nine databases including Medline were searched through September 2015. Randomized controlled trials evaluating complementary and alternative medicine for PE were included. Studies were included if they reported on intravaginal ejaculatory latency time (IELT) and/or another validated PE measurement. Adverse effects were summarized. Ten randomized controlled trials were included. Two assessed acupuncture, five assessed Chinese herbal medicine, one assessed Ayurvedic herbal medicine, and two assessed topical "severance secret" cream. Risk of bias was unclear in all studies because of unclear allocation concealment or blinding, and only five studies reported stopwatch-measured IELT. Acupuncture slightly increased IELT over placebo in one study (mean difference [MD] = 0.55 minute, P = .001). In another study, Ayurvedic herbal medicine slightly increased IELT over placebo (MD = 0.80 minute, P = .001). Topical severance secret cream increased IELT over placebo in two studies (MD = 8.60 minutes, P medicine with selective serotonin reuptake inhibitors (SSRIs) favored SSRIs (MD = 1.01 minutes, P = .02). However, combination treatment with Chinese medicine plus SSRIs improved IELT over SSRIs alone (two studies; MD = 1.92 minutes, P medicine alone (two studies; MD = 2.52 minutes, P effects were not consistently assessed but where reported were generally mild. There is preliminary evidence for the effectiveness of acupuncture, Chinese herbal medicine, Ayurvedic herbal medicine, and topical severance secret cream in improving IELT and other outcomes. However, results are based on clinically

Combustion of solid alternative fuels in the cement kiln burner

DEFF Research Database (Denmark)

Nørskov, Linda Kaare

In the cement industry there is an increasing environmental and financial motivation for substituting conventional fossil fuels with alternative fuels, being biomass or waste derived fuels. However, the introduction of alternative fuels may influence emissions, cement product quality, process...... stability, and process efficiency. Alternative fuel substitution in the calciner unit has reached close to 100% at many cement plants and to further increase the use of alternative fuels rotary kiln substitution must be enhanced. At present, limited systematic knowledge of the alternative fuel combustion...... properties and the influence on the flame formation is available. In this project a scientific approach to increase the fundamental understanding of alternative fuel conversion in the rotary kiln burner is employed through literature studies, experimental combustion characterisation studies, combustion...

The Technical Quality of Test Items Generated Using a Systematic Approach to Item Writing.

Science.gov (United States)

Siskind, Theresa G.; Anderson, Lorin W.

The study was designed to examine the similarity of response options generated by different item writers using a systematic approach to item writing. The similarity of response options to student responses for the same item stems presented in an open-ended format was also examined. A non-systematic (subject matter expertise) approach and a…

A systematic approach for development of a PWR cladding corrosion model

International Nuclear Information System (INIS)

Quecedo, M.; Serna, J.J.; Weiner, R.A.; Kersting, P.J.

2001-01-01

A new model for the in-reactor corrosion of Improved (low-tin) Zircaloy-4 cladding irradiated in commercial pressurized water reactors (PWRs) is described. The model is based on an extensive database of PWR fuel cladding corrosion data from fuel irradiated in commercial reactors, with a range of fuel duty and coolant chemistry control strategies which bracket current PWR fuel management practices. The fuel thermal duty with these current fuel management practices is characterized by a significant amount of sub-cooled nucleate boiling (SNB) during the fuel's residence in-core, and the cladding corrosion model is very sensitive to the coolant heat transfer models used to calculate the coolant temperature at the oxide surface. The systematic approach to developing the new corrosion model therefore began with a review and evaluation of several alternative models for the forced convection and SNB coolant heat transfer. The heat transfer literature is not sufficient to determine which of these heat transfer models is most appropriate for PWR fuel rod operating conditions, and the selection of the coolant heat transfer model used in the new cladding corrosion model has been coupled with a statistical analysis of the in-reactor corrosion enhancement factors and their impact on obtaining the best fit to the cladding corrosion data. The in-reactor corrosion enhancement factors considered in this statistical analysis are based on a review of the current literature for PWR cladding corrosion phenomenology and models. Fuel operating condition factors which this literature review indicated could have a significant effect on the cladding corrosion performance were also evaluated in detail in developing the corrosion model. An iterative least squares fitting procedure was used to obtain the model coefficients and select the coolant heat transfer models and in-reactor corrosion enhancement factors. This statistical procedure was completed with an exhaustive analysis of the model

Model validation: a systemic and systematic approach

International Nuclear Information System (INIS)

Sheng, G.; Elzas, M.S.; Cronhjort, B.T.

1993-01-01

The term 'validation' is used ubiquitously in association with the modelling activities of numerous disciplines including social, political natural, physical sciences, and engineering. There is however, a wide range of definitions which give rise to very different interpretations of what activities the process involves. Analyses of results from the present large international effort in modelling radioactive waste disposal systems illustrate the urgent need to develop a common approach to model validation. Some possible explanations are offered to account for the present state of affairs. The methodology developed treats model validation and code verification in a systematic fashion. In fact, this approach may be regarded as a comprehensive framework to assess the adequacy of any simulation study. (author)

SHERPA: A systematic human error reduction and prediction approach

International Nuclear Information System (INIS)

Embrey, D.E.

1986-01-01

This paper describes a Systematic Human Error Reduction and Prediction Approach (SHERPA) which is intended to provide guidelines for human error reduction and quantification in a wide range of human-machine systems. The approach utilizes as its basic current cognitive models of human performance. The first module in SHERPA performs task and human error analyses, which identify likely error modes, together with guidelines for the reduction of these errors by training, procedures and equipment redesign. The second module uses a SARAH approach to quantify the probability of occurrence of the errors identified earlier, and provides cost benefit analyses to assist in choosing the appropriate error reduction approaches in the third module

Risk as economic category: systematics scientific approach and refinement contents

Directory of Open Access Journals (Sweden)

V.G. Vygovskyy

2015-03-01

Full Text Available The paper studies the categorical-conceptual apparatus of risk and its refinement based on a critical analysis of existing systematic scientific approaches. Determined that in the refinement of the economic nature of the risk of a number of controversial issues: the definition of the objective or subjective nature of risk; matching of concepts such as «risk», «danger», «loss», «probability of loss»; definition of negative or positive consequences of risk; identification of risk with its consequences, or source of origin, which makes the relevance of research topics. As a result of scientific research has been refined interpretation of risk as an economic category, the characteristics of the company associated with the probability of unforeseen situations that may lead to negative and positive impacts, assessment of which requires the development of alternatives for management decisions. Clarification of the definition focuses on the possibility (probability of a favorable (unfavorable events which require certain corrective action management unit of the enterprise. The author emphasizes the mandatory features of the category of «risk», in particular: the concept of risk is always associated with the uncertainty of the future; event occurring has implications for the enterprise (both negative and positive; consequences for necessitates the development of a number of alternative solutions to the possible elimination of the negative consequences of risky events; risk – a mandatory attribute of modern management (its value is enhanced in terms of market conditions; subject to risk assessment and management by the company. Dedicated and updated features contribute to the clarification of the nature of the economic risk and categorical conceptual apparatus of risk management.

Seismic qualification of motor operated valves - alternate approach

International Nuclear Information System (INIS)

Bruck, P.M.; Eissa, M.A.

1998-01-01

This paper presents a potential alternate method for determining operating capacity of motor-operated valves subjected to seismic and other applicable loadings. As a result of programs at nuclear facilities to ensure the operational capability of MOVs (under NRC GL89-10), extensive analytical focus to develop the structural capability of valves has ensued. In the past, seismic qualification of valves typically addressed the strength of the topwork structure to resist inertial loading from excitation of the large valve actuator mass. These evaluations paid little or no consideration to the loading resulting from valve closing forces. The focus of the recent efforts is to develop the maximum operational capability of the valve, in terms of thrust, with consideration of seismic and other services loading as applicable. The alternate method outlined in this paper presents a series of thrust capacity curves, with reduction factors for seismic loading which can be applied and developed to determine safe thrust loadings without performing extensive analytical effort. A similar approach was put forward by the SQUG GIP approach to MOVs to ensure the safe operation of valves based on past earthquake experience. However, the GIP approach cannot be used to determine safe operational loads and thus has limited use in the necessary analysis required for GL89-10 programs at nuclear facilities. (orig.)

The Elements of Language Curriculum: A Systematic Approach to Program Development.

Science.gov (United States)

Brown, James Dean

A systematic approach to second language curriculum development is outlined, enumerating the phases and activities involved in developing and implementing a sound and effective language program. The first chapter describes a system whereby all language teaching activities can be classified into approaches, syllabuses, techniques, exercises, or…

Alternative Contracting and Ownership Approaches for New Nuclear Power Plants

International Nuclear Information System (INIS)

2014-09-01

This publication examines alternative contracting and ownership approaches for the development, construction, commissioning, operation, and decommissioning of new nuclear power plants. It identifies issues faced by IAEA Member States considering the applicability of such approaches to their respective national programmes. Two new approaches to nuclear project development are analysed. These are, firstly, the Build-Own-Operate (BOO)/Build-Own-Operate-Transfer (BOO(T)) and, secondly, Regional approaches. The information includes practical examples, current practices, and case studies, and reflects the presentations and discussions that took place in a series of IAEA meetings on this topic

Alternative approaches to improve site investigations

International Nuclear Information System (INIS)

Beach, R.B.; Silka, L.R.

1992-01-01

Common complaints about standard investigations at hazardous waste sites include high costs and long time frames. Investigations at military bases as part of the installation restoration program or base closures suffer additionally from nonuniformity of approach and results and redundancy of work effort conducted by multiple environmental contractors. The problems of high costs and long time frames can be minimized by the consistent use of alternative sampling methods (such as soil gas surveys) and the utilization of analytical screening procedures at both on-site and off-site laboratories. Acceptable data quality is maintained by several procedures. Incorporation of quality control measures (10 % frequency), such as matrix spikes and duplicates, into the alternative analytical techniques allows assessment of the data quality relative to predetermined data quality objectives (DQOs). Confirmation of the screening results (10% frequency) using standard US EPA methods, such as the contract laboratory program (CLP) statement of work (SOW), allows an additional evaluation of the data accuracy. Depending on the investigative objectives, knowledge based computer systems (expert systems,) could be used to improve uniformity of site evaluations. Several case histories will be presented demonstrating how soil gas surveys, screening analyses and standard analyses can be utilized to give increased site information in a reduced time frame and at a cost savings of 30 to 40%. One case history illustrates a screening technique developed by the author for polynuclear aromatics (semi-volatile organic compounds) that can be conducted at a cost savings of 90% relative to a standard US EPA method. A comparison of the phased investigative approach to one using an integrated field team is presented for fuel spill or UST areas

The Mind-Body Connection - Complementary and Alternative Approaches to Health

Science.gov (United States)

... Navigation Bar Home Current Issue Past Issues The Mind-Body Connection Complementary and Alternative Approaches to Health ... Also, a 2007 study found that Tai Chi boosts resistance to the shingles virus in older adults." ...

Learning from the application of the systematic approach to training

International Nuclear Information System (INIS)

Haber, S.B.; Yoder, J.A.

1998-01-01

The paper describes the objectives, lessons learned, key accomplishments and related activities of the application of the systematic approach to training initiated by DOE in Russia and Ukraine in 1992 focused on single facility in each country

Systematic Approach for Development of Innovative Infrastructure

Directory of Open Access Journals (Sweden)

Zarema Muhamedova

2014-07-01

Full Text Available The necessity for development of innovative infrastructure is proved. Its nature, reasonability of systematic approach use and purpose has been identified. The author suggests considering the regime of infrastructural provision aimed at offering horizontal and vertical integration of institutions. This model is designed to create and integral complex for innovative support. The grounds of establishment the state politics are identified. The conceptual recommendations on its development and formation of relevant model, strategy and regulatory mechanism are outlined.

A Systematic Approach to Identify Promising New Items for Small to Medium Enterprises: A Case Study

Directory of Open Access Journals (Sweden)

Sukjae Jeong

2016-11-01

Full Text Available Despite the growing importance of identifying new business items for small and medium enterprises (SMEs, most previous studies focus on conglomerates. The paucity of empirical studies has also led to limited real-life applications. Hence, this study proposes a systematic approach to find new business items (NBIs that help the prospective SMEs develop, evaluate, and select viable business items to survive the competitive environment. The proposed approach comprises two stages: (1 the classification of diversification of SMEs; and (2 the searching and screening of business items. In the first stage, SMEs are allocated to five groups, based on their internal technological competency and external market conditions. In the second stage, based on the types of SMEs identified in the first stage, a set of alternative business items is derived by combining the results of portfolio analysis and benchmarking analysis. After deriving new business items, a market and technology-driven matrix analysis is utilized to screen suitable business items, and the Bruce Merrifield-Ohe (BMO method is used to categorize and identify prospective items based on market attractiveness and internal capability. To illustrate the applicability of the proposed approach, a case study is presented.

Standardisation of defined approaches for skin sensitisation testing to support regulatory use and international adoption: position of the International Cooperation on Alternative Test Methods.

Science.gov (United States)

Casati, S; Aschberger, K; Barroso, J; Casey, W; Delgado, I; Kim, T S; Kleinstreuer, N; Kojima, H; Lee, J K; Lowit, A; Park, H K; Régimbald-Krnel, M J; Strickland, J; Whelan, M; Yang, Y; Zuang, Valérie

2018-02-01

Skin sensitisation is the regulatory endpoint that has been at the centre of concerted efforts to replace animal testing in recent years, as demonstrated by the Organisation for Economic Co-operation and Development (OECD) adoption of five non-animal methods addressing mechanisms under the first three key events of the skin sensitisation adverse outcome pathway. Nevertheless, the currently adopted methods, when used in isolation, are not sufficient to fulfil regulatory requirements on the skin sensitisation potential and potency of chemicals comparable to that provided by the regulatory animal tests. For this reason, a number of defined approaches integrating data from these methods with other relevant information have been proposed and documented by the OECD. With the aim to further enhance regulatory consideration and adoption of defined approaches, the European Union Reference Laboratory for Alternatives to Animal testing in collaboration with the International Cooperation on Alternative Test Methods hosted, on 4-5 October 2016, a workshop on the international regulatory applicability and acceptance of alternative non-animal approaches, i.e., defined approaches, to skin sensitisation assessment of chemicals used in a variety of sectors. The workshop convened representatives from more than 20 regulatory authorities from the European Union, United States, Canada, Japan, South Korea, Brazil and China. There was a general consensus among the workshop participants that to maximise global regulatory acceptance of data generated with defined approaches, international harmonisation and standardisation are needed. Potential assessment criteria were defined for a systematic evaluation of existing defined approaches that would facilitate their translation into international standards, e.g., into a performance-based Test Guideline. Informed by the discussions at the workshop, the ICATM members propose practical ways to further promote the regulatory use and facilitate

A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome

Science.gov (United States)

Häuser, Winfried; Dobos, Gustav; Langhorst, Jost

2015-01-01

Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety. PMID:26246841

A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome

Directory of Open Access Journals (Sweden)

Romy Lauche

2015-01-01

Full Text Available Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM for the fibromyalgia syndrome (FMS. Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety.

A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome.

Science.gov (United States)

Lauche, Romy; Cramer, Holger; Häuser, Winfried; Dobos, Gustav; Langhorst, Jost

2015-01-01

Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety.

SYSTEMATIZATION OF SCIENTIFIC APPROACHES TO THE INTERPRETATION OF INFORMATION ECONOMY

Directory of Open Access Journals (Sweden)

Nataliya Kholiavko

2017-09-01

Full Text Available The purpose of the article is to analyse and systematize scientific approaches to the interpretation of the essence of the information economy. The research object: scientific approaches to the interpretation of the essence of the concept of “information economy”. The theoretical and methodological base of the research consists of works by D. Bell, Z. Brzezinski, J. Baudrillard, M. Castells, Yoneji Masuda, F. Machlup, M. Porat, A. Toffler, which are devoted to issues of development of information society. Analysis of recent research and publications allows noting an increasing scientific interest in issues of formation of the economy of information type. The essence and features of information economy are considered in scientific papers of scholars such as Hrynkevych S., Iliash A., Krystynevych S., Malyk I., Nikolaiev Ye., Bazhal Yu., Tolstiakov R., Shkarlet S., Fedulova L., Chukhno A., and others. Research methods: analysis, content analysis, synthesis, system method. Increasing scientific interest in the formation of the information economy leads to an increase in the number of publications on this topic; pluralism of scientific approaches to the consideration of the essence of the information economy actualizes the need for their systematization. The theory of information economy logically follows and is a component of the theory of the development of information society. Along with it, there is an approach in the scientific literature, according to which scholars identify the concept of information society and information economy. In our opinion, this approach is not well-balanced, since the term “information society” is inherently wider than “information economy”. The latter can be considered as an inherent component of the information society, which development is determined by a number of specific factors. In other words, these terms are closely interrelated and they should be investigated in the context of links between them

The value of postmortem computed tomography as an alternative for autopsy in trauma victims: a systematic review

International Nuclear Information System (INIS)

Scholing, M.; Saltzherr, T.P.; Fung Kon Jin, P.H.P.; Ponsen, K.J.; Goslings, J.C.; Reitsma, J.B.; Lameris, J.S.

2009-01-01

The aim of this study was to assess the role of postmortem computed tomography (PMCT) as an alternative for autopsy in determining the cause of death and the identification of specific injuries in trauma victims. A systematic review was performed by searching the EMBASE and MEDLINE databases. Articles were eligible if they reported both PMCT as well as autopsy findings and included more than one trauma victim. Two reviewers independently assessed the eligibility and quality of the articles. The outcomes were described in terms of the percentage agreement on causes of death and amount of injuries detected. The data extraction and analysis were performed together. Fifteen studies were included describing 244 victims. The median sample size was 13 (range 5-52). The percentage agreement on the cause of death between PMCT and autopsy varied between 46 and 100%. The overall amount of injuries detected on CT ranged from 53 to 100% compared with autopsy. Several studies suggested that PMCT was capable of identifying injuries not detected during normal autopsy. This systematic review provides inconsistent evidence as to whether PMCT is a reliable alternative for autopsy in trauma victims. PMCT has promising features in postmortem examination suggesting PMCT is a good alternative for a refused autopsy or a good adjunct to autopsy because it detects extra injuries overseen during autopsies. To examine the value of PMCT in trauma victims there is a need for well-designed and larger prospective studies. (orig.)

The role of complementary and alternative medicine in the treatment of eating disorders: A systematic review.

Science.gov (United States)

Fogarty, Sarah; Smith, Caroline A; Hay, Phillipa

2016-04-01

This systematic review critically appraises the role of complementary and alternative medicine in the treatment of those with an eating disorder. Sixteen studies were included in the review. The results of this review show that the role of complementary and alternative medicine in the treatment of those with an eating disorder is unclear and further studies should be conducted. A potential role was found for massage and bright light therapy for depression in those with Bulimia Nervosa and a potential role for acupuncture and relaxation therapy, in the treatment of State Anxiety, for those with an eating disorder. The role of these complementary therapies in treating eating disorders should only be provided as an adjunctive treatment only. Copyright © 2016 Elsevier Ltd. All rights reserved.

Initial impact of a systematic multidisciplinary approach on the management of patients with gastroenteropancreatic neuroendocrine tumor.

LENUS (Irish Health Repository)

Tamagno, Gianluca

2013-10-01

According to the international guidelines, a multidisciplinary approach is currently advised for the optimal care of patients with a gastroenteropancreatic neuroendocrine tumor (GEP NET). In our institution (tertiary care center), a systematic multidisciplinary approach was established in May 2007. In this study, we have aimed to assess the initial impact of establishing a systematic multidisciplinary approach to the management of GEP NET patients. We have collected and compared the biochemical, imaging, and pathological data and the therapeutic strategies in GEP NET patients diagnosed, treated, or followed-up from January 1993 to April 2007 versus GEP NET patients attending our institution after the multidisciplinary approach starting, from May 2007 to October 2008. Data of 91 patients before and 42 patients after the establishment of the multidisciplinary approach (total: 133 consecutive GEP NET patients) have been finally collected and analyzed. Before the establishment of the multidisciplinary approach, a lack of consistency in the biochemical, imaging, and pathological findings before treatment initiation as well as during follow-up of GEP NET patients was identified. These inconsistencies have been reduced by the systematic multidisciplinary approach. In addition, the therapeutic management of GEP NET patients has been altered by the multidisciplinary approach and became more consistent with recommended guidelines. We think that a systematic multidisciplinary approach significantly impacts on GEP NET patient care and should be established in all centers dealing with these tumors.

Alternative algebraic approaches in quantum chemistry

International Nuclear Information System (INIS)

Mezey, Paul G.

2015-01-01

Various algebraic approaches of quantum chemistry all follow a common principle: the fundamental properties and interrelations providing the most essential features of a quantum chemical representation of a molecule or a chemical process, such as a reaction, can always be described by algebraic methods. Whereas such algebraic methods often provide precise, even numerical answers, nevertheless their main role is to give a framework that can be elaborated and converted into computational methods by involving alternative mathematical techniques, subject to the constraints and directions provided by algebra. In general, algebra describes sets of interrelations, often phrased in terms of algebraic operations, without much concern with the actual entities exhibiting these interrelations. However, in many instances, the very realizations of two, seemingly unrelated algebraic structures by actual quantum chemical entities or properties play additional roles, and unexpected connections between different algebraic structures are often giving new insight. Here we shall be concerned with two alternative algebraic structures: the fundamental group of reaction mechanisms, based on the energy-dependent topology of potential energy surfaces, and the interrelations among point symmetry groups for various distorted nuclear arrangements of molecules. These two, distinct algebraic structures provide interesting interrelations, which can be exploited in actual studies of molecular conformational and reaction processes. Two relevant theorems will be discussed

Alternative algebraic approaches in quantum chemistry

Energy Technology Data Exchange (ETDEWEB)

Mezey, Paul G., E-mail: paul.mezey@gmail.com [Canada Research Chair in Scientific Modeling and Simulation, Department of Chemistry and Department of Physics and Physical Oceanography, Memorial University of Newfoundland, 283 Prince Philip Drive, St. John' s, NL A1B 3X7 (Canada)

2015-01-22

Various algebraic approaches of quantum chemistry all follow a common principle: the fundamental properties and interrelations providing the most essential features of a quantum chemical representation of a molecule or a chemical process, such as a reaction, can always be described by algebraic methods. Whereas such algebraic methods often provide precise, even numerical answers, nevertheless their main role is to give a framework that can be elaborated and converted into computational methods by involving alternative mathematical techniques, subject to the constraints and directions provided by algebra. In general, algebra describes sets of interrelations, often phrased in terms of algebraic operations, without much concern with the actual entities exhibiting these interrelations. However, in many instances, the very realizations of two, seemingly unrelated algebraic structures by actual quantum chemical entities or properties play additional roles, and unexpected connections between different algebraic structures are often giving new insight. Here we shall be concerned with two alternative algebraic structures: the fundamental group of reaction mechanisms, based on the energy-dependent topology of potential energy surfaces, and the interrelations among point symmetry groups for various distorted nuclear arrangements of molecules. These two, distinct algebraic structures provide interesting interrelations, which can be exploited in actual studies of molecular conformational and reaction processes. Two relevant theorems will be discussed.

Condensed and Updated Version of the Systematic Approach Meteorological Knowledge Base Western North Pacific

OpenAIRE

Carr, Lester E., III; Elsberry, Russell L.; Boothe, Mark A.

1997-01-01

The views expressed in this report are those of the authors and do not reflect the official policy or position of the Department of Defense. The meteorological knowledge base for the Systematic and Integrated Approach to Tropical Cydone Track Forecasting proposed by Carr and Elsberry has evolved as additional research has been completed. This Systematic Approach has been applied in the eastern and central North Pacific, and in the Southern Hemisphere, a number of conceptual models have bee...

Alternative Endpoints and Approaches for the Remediation of Contaminated Groundwater at Complex Sites - 13426

International Nuclear Information System (INIS)

Deeb, Rula A.; Hawley, Elisabeth L.

2013-01-01

The goal of United States (U.S.) Department of Energy's (DOE)'s environmental remediation programs is to restore groundwater to beneficial use, similar to many other Federal and state environmental cleanup programs. Based on past experience, groundwater remediation to pre-contamination conditions (i.e., drinking water standards or non-detectable concentrations) can be successfully achieved at many sites. At a subset of the most complex sites, however, complete restoration is not likely achievable within the next 50 to 100 years using today's technology. This presentation describes several approaches used at complex sites in the face of these technical challenges. Many complex sites adopted a long-term management approach, whereby contamination was contained within a specified area using active or passive remediation techniques. Consistent with the requirements of their respective environmental cleanup programs, several complex sites selected land use restrictions and used risk management approaches to accordingly adopt alternative cleanup goals (alternative endpoints). Several sites used long-term management designations and approaches in conjunction with the alternative endpoints. Examples include various state designations for groundwater management zones, technical impracticability (TI) waivers or greater risk waivers at Superfund sites, and the use of Monitored Natural Attenuation (MNA) or other passive long-term management approaches over long time frames. This presentation will focus on findings, statistics, and case studies from a recently-completed report for the Department of Defense's Environmental Security Technology Certification Program (ESTCP) (Project ER-0832) on alternative endpoints and approaches for groundwater remediation at complex sites under a variety of Federal and state cleanup programs. The primary objective of the project was to provide environmental managers and regulators with tools, metrics, and information needed to evaluate

Alternative Endpoints and Approaches for the Remediation of Contaminated Groundwater at Complex Sites - 13426

Energy Technology Data Exchange (ETDEWEB)

Deeb, Rula A.; Hawley, Elisabeth L. [ARCADIS, U.S., 2000 Powell St., 7th Floor, Emeryville, California 94608 (United States)

2013-07-01

The goal of United States (U.S.) Department of Energy's (DOE)'s environmental remediation programs is to restore groundwater to beneficial use, similar to many other Federal and state environmental cleanup programs. Based on past experience, groundwater remediation to pre-contamination conditions (i.e., drinking water standards or non-detectable concentrations) can be successfully achieved at many sites. At a subset of the most complex sites, however, complete restoration is not likely achievable within the next 50 to 100 years using today's technology. This presentation describes several approaches used at complex sites in the face of these technical challenges. Many complex sites adopted a long-term management approach, whereby contamination was contained within a specified area using active or passive remediation techniques. Consistent with the requirements of their respective environmental cleanup programs, several complex sites selected land use restrictions and used risk management approaches to accordingly adopt alternative cleanup goals (alternative endpoints). Several sites used long-term management designations and approaches in conjunction with the alternative endpoints. Examples include various state designations for groundwater management zones, technical impracticability (TI) waivers or greater risk waivers at Superfund sites, and the use of Monitored Natural Attenuation (MNA) or other passive long-term management approaches over long time frames. This presentation will focus on findings, statistics, and case studies from a recently-completed report for the Department of Defense's Environmental Security Technology Certification Program (ESTCP) (Project ER-0832) on alternative endpoints and approaches for groundwater remediation at complex sites under a variety of Federal and state cleanup programs. The primary objective of the project was to provide environmental managers and regulators with tools, metrics, and information needed

A Systematic Approach for the Design and Analysis of Reaction-Separation Systems with Recycle

DEFF Research Database (Denmark)

Gani, Rafiqul; Jimenez, Edgar Ramirez

2004-01-01

This paper presents a methodology for a systematic model-based analysis and the results obtained from it for an integrated design and analysis of reaction-separation systems with recycle. The methodology (systematic approach) consists of three stages where stage 1 identifies the limiting values...

Integrating exposure into chemical alternatives assessment using a qualitative approach

DEFF Research Database (Denmark)

Greggs, Bill; Arnold, Scott; Burns, T. E.

2016-01-01

, other attributes beyond hazard are also important, including exposure, risk, life-cycle impacts, performance, cost, and social responsibility. Building on the 2014 recommendations by the U.S. National Academy of Sciences to improve AA decisions by including comparative exposure assessment, the HESI...... Sustainable Chemical Alternatives Technical Committee, which consists of scientists from academia, industry, government, and NGOs, has developed a qualitative comparative exposure approach. Conducting such a comparison can screen for alternatives that are expected to have a higher human or environmental...... not necessarily reflect the views or policies of the U.S. Environmental Protection Agency....

Complementary and alternative approaches used by parents of children with epilepsy on epilepsy management.

Science.gov (United States)

Işler, Ayşegül; Turan, Fatma Dilek; Gözüm, Sebahat; Oncel, Selma

2014-03-01

The aim of this study was to determine the complementary and alternative approaches used by parents of children with epilepsy on epilepsy management. This descriptive study included a total of 304 parents of children with epilepsy aged between 0 and 18years evaluated at the Pediatric Neurology Clinic of Akdeniz University Hospital in Turkey between January and May 2013. Data were collected by using a questionnaire developed by the researchers. It was determined that all the parents use complementary and alternative approaches for their children with epilepsy, and the most common approaches are praying (99.3%); keeping their children away from the effects of smoking (79.8%); feeding their children walnuts (79.6%), butter (59.2%), and bone marrow (58.6%); providing their children with good quality sleep (58.6%); and enabling their children to play games (51%). The approaches commonly applied during seizures include praying (96.2%), comforting their children in their arms and showing affection (55.6%), waiting for seizures to finish at home (45.7%), and laying children on their side (41.1%). Of parents, 98% stated that alternative approaches enable them to control their child's seizures, 100% said that alternative approaches have no adverse effect, and 98.4% stated that they will continue to use these approaches. The children's approaches to cope with epilepsy included looking after pets (72.7%), listening to music (70.1%), watching television (64.5%), playing games (55.3%), praying (51%), and spending time with friends (48.7%). Most of the approaches used by parents and children with epilepsy for the management of illness are determined to consist of complementary approaches that may contribute to management of epilepsy. Knowing the approaches of parents and children with epilepsy that could adversely affect disease management is important for educating parents and children to avoid these potentially harmful interventions. Copyright © 2013 Elsevier Inc. All rights

A systematic approach to designing statistically powerful heteroscedastic 2 × 2 factorial studies while minimizing financial costs

Directory of Open Access Journals (Sweden)

Show-Li Jan

2016-08-01

Full Text Available Abstract Background The 2 × 2 factorial design is widely used for assessing the existence of interaction and the extent of generalizability of two factors where each factor had only two levels. Accordingly, research problems associated with the main effects and interaction effects can be analyzed with the selected linear contrasts. Methods To correct for the potential heterogeneity of variance structure, the Welch-Satterthwaite test is commonly used as an alternative to the t test for detecting the substantive significance of a linear combination of mean effects. This study concerns the optimal allocation of group sizes for the Welch-Satterthwaite test in order to minimize the total cost while maintaining adequate power. The existing method suggests that the optimal ratio of sample sizes is proportional to the ratio of the population standard deviations divided by the square root of the ratio of the unit sampling costs. Instead, a systematic approach using optimization technique and screening search is presented to find the optimal solution. Results Numerical assessments revealed that the current allocation scheme generally does not give the optimal solution. Alternatively, the suggested approaches to power and sample size calculations give accurate and superior results under various treatment and cost configurations. Conclusions The proposed approach improves upon the current method in both its methodological soundness and overall performance. Supplementary algorithms are also developed to aid the usefulness and implementation of the recommended technique in planning 2 × 2 factorial designs.

Oral Pathology in Clinical Dentistry: A systematic approach

Directory of Open Access Journals (Sweden)

R V Subramanyam

2014-01-01

Full Text Available The dental clinician frequently comes across lesions that involve the hard and soft tissues of the oral cavity. Most of these conditions do not pose a diagnostic problem for the dental surgeon. However, the clinical dentist is sometimes accosted with a lesion, the diagnosis of which is not only challenging, but influencing the choice of treatment. This review article provides a systematic and logical approach for diagnosing common lesions encountered in the dental practice.

Malzeme Taşıma Sistemi Alternatiflerinin Değerlendirilmesinde Bulanık-Promethee Yaklaşımı = Evaluating Material Handling System Alternatives Using Fuzzy-Promethee Approach

Directory of Open Access Journals (Sweden)

Bahadır GÜLSÜN

2011-01-01

Full Text Available Material handling system selection process has an important effect on productivity of manufacturing systems. Considering the importance of this process, it can be seen that there is a necessity to establish a systematic approach. In this study, to determine the best material handling system alternative, PROMETHEE approach is utilized. With the aim of taking into account the vagueness in the evaluation process and obtaining decision maker evaluations in an easier way with linguistic terms, fuzzy sets are utilized. To this end, a modified version of PROMETHEE is used. To foster the better understanding of the methodology, a real life application of a manufacturer is realized.

Bridge approach slabs for Missouri DOT field evaluation of alternative and cost efficient bridge approach slabs.

Science.gov (United States)

2013-05-01

Based on a recent study on cost efficient alternative bridge approach slab (BAS) designs (Thiagarajan et : al. 2010) has recommended three new BAS designs for possible implementation by MoDOT namely a) 20 feet cast-inplace : slab with sleeper slab (C...

Dissertation to Journal Article: A Systematic Approach

Directory of Open Access Journals (Sweden)

Brychan Thomas

2012-01-01

Full Text Available The aim of the paper is to elucidate a systematic approach to convert a Masters dissertation into a journal article. This approach has involved a fundamental thematic review of the literature concerning the conversion of dissertations into journal articles. From these sources pertinent approaches, processes, lessons, and guidance have been noted and analysed. By undertaking this distillation of relevant material, to enable the efficient conversion of dissertations into journal articles, appropriate procedures and conclusions have been compiled. Findings present current thinking on the conversion of a dissertation into a journal paper in terms of how dissertations differ from journal articles, reframing for publication, rethinking the material, trimming the length, time taken to rewrite the material, specific lessons, and adapting for publication. Recommendations provided in the paper will enable staff to take this course of action when developing their publication portfolio to become more research active and to make an important contribution to the publication output of their department/school/faculty, especially with regard to assessment exercises such as the Research Excellence Framework. The value of the paper is that by following appropriate approaches, processes, and procedures it is possible to convert a good dissertation into a ranked journal article.

Analysis phase of systematic approach to training (SAT) for nuclear plant personnel

International Nuclear Information System (INIS)

2000-08-01

The IAEA and many Member States have recognized the benefits of a systematic approach when training nuclear power plant personnel. The Systematic Approach to Training (SAT) fully described in the IAEA publications, is recommended as the best practice for attaining and maintaining the competence and qualification of NPP personnel. Typically, SAT is organised into distinct phases of Analysis, Design, Development, Implementation, and Evaluation, and relies on Feedback as a process for continuous improvement This document is addressed to nuclear power operating organisations facing the challenge of developing training programs for their own personnel. The intention was to provide Member States with examples of the Analysis phase to form foundation of SAT-based training programs. This document is also available in CD form

Integrated Approaches to Occupational Health and Safety: A Systematic Review.

Science.gov (United States)

Cooklin, A; Joss, N; Husser, E; Oldenburg, B

2017-09-01

The study objective was to conduct a systematic review of the effectiveness of integrated workplace interventions that combine health promotion with occupational health and safety. Electronic databases (n = 8), including PsychInfo and MEDLINE, were systematically searched. Studies included were those that reported on workplace interventions that met the consensus definition of an "integrated approach," published in English, in the scientific literature since 1990. Data extracted were occupation, worksite, country, sample size, intervention targets, follow-up period, and results reported. Quality was assessed according to American College of Occupational and Environmental Medicine Practice Guidelines. Heterogeneity precluded formal meta-analyses. Results were classified according to the outcome(s) assessed into five categories (health promotion, injury prevention, occupational health and safety management, psychosocial, and return-on-investment). Narrative synthesis of outcomes was performed. A total of 31 eligible studies were identified; 23 (74%) were (quasi-)experimental trials. Effective interventions were most of those aimed at improving employee physical or mental health. Less consistent results were reported from integrated interventions targeting occupational health and safety management, injury prevention, or organizational cost savings. Integrated approaches have been posed as comprehensive solutions to complex issues. Empirical evidence, while still emerging, provides some support for this. Continuing investment in, and evaluation of, integrated approaches are worthwhile.

Fixed-location hydroacoustic monitoring designs for estimating fish passage using stratified random and systematic sampling

International Nuclear Information System (INIS)

Skalski, J.R.; Hoffman, A.; Ransom, B.H.; Steig, T.W.

1993-01-01

Five alternate sampling designs are compared using 15 d of 24-h continuous hydroacoustic data to identify the most favorable approach to fixed-location hydroacoustic monitoring of salmonid outmigrants. Four alternative aproaches to systematic sampling are compared among themselves and with stratified random sampling (STRS). Stratifying systematic sampling (STSYS) on a daily basis is found to reduce sampling error in multiday monitoring studies. Although sampling precision was predictable with varying levels of effort in STRS, neither magnitude nor direction of change in precision was predictable when effort was varied in systematic sampling (SYS). Furthermore, modifying systematic sampling to include replicated (e.g., nested) sampling (RSYS) is further shown to provide unbiased point and variance estimates as does STRS. Numerous short sampling intervals (e.g., 12 samples of 1-min duration per hour) must be monitored hourly using RSYS to provide efficient, unbiased point and interval estimates. For equal levels of effort, STRS outperformed all variations of SYS examined. Parametric approaches to confidence interval estimates are found to be superior to nonparametric interval estimates (i.e., bootstrap and jackknife) in estimating total fish passage. 10 refs., 1 fig., 8 tabs

Risk Financing for Schools: The Capital Markets Approach.

Science.gov (United States)

Rudolph, Richard G.

1988-01-01

The capital markets approach is an alternative means of risk financing whereby a school system establishes and controls its own insurance company and makes systematic contributions to pay for expected and anticipated losses and their associated costs. (MLF)

A Systematic Approach to Food Variety Classification as a Tool in ...

African Journals Online (AJOL)

A Systematic Approach to Food Variety Classification as a Tool in Dietary ... and food variety (count of all dietary items consumed during the recall period up to the ... This paper presents a pilot study carried out with an aim of demonstrating the ...

Using text mining for study identification in systematic reviews: a systematic review of current approaches.

Science.gov (United States)

O'Mara-Eves, Alison; Thomas, James; McNaught, John; Miwa, Makoto; Ananiadou, Sophia

2015-01-14

The large and growing number of published studies, and their increasing rate of publication, makes the task of identifying relevant studies in an unbiased way for inclusion in systematic reviews both complex and time consuming. Text mining has been offered as a potential solution: through automating some of the screening process, reviewer time can be saved. The evidence base around the use of text mining for screening has not yet been pulled together systematically; this systematic review fills that research gap. Focusing mainly on non-technical issues, the review aims to increase awareness of the potential of these technologies and promote further collaborative research between the computer science and systematic review communities. Five research questions led our review: what is the state of the evidence base; how has workload reduction been evaluated; what are the purposes of semi-automation and how effective are they; how have key contextual problems of applying text mining to the systematic review field been addressed; and what challenges to implementation have emerged? We answered these questions using standard systematic review methods: systematic and exhaustive searching, quality-assured data extraction and a narrative synthesis to synthesise findings. The evidence base is active and diverse; there is almost no replication between studies or collaboration between research teams and, whilst it is difficult to establish any overall conclusions about best approaches, it is clear that efficiencies and reductions in workload are potentially achievable. On the whole, most suggested that a saving in workload of between 30% and 70% might be possible, though sometimes the saving in workload is accompanied by the loss of 5% of relevant studies (i.e. a 95% recall). Using text mining to prioritise the order in which items are screened should be considered safe and ready for use in 'live' reviews. The use of text mining as a 'second screener' may also be used cautiously

Short Shrift to Long Lists: An Alternative Approach to the Development of Performance Standards for School Principals.

Science.gov (United States)

Louden, William; Wildy, Helen

1999-01-01

Describes examples of standards frameworks for principals' work operant in three countries and describes an alternative approach based on interviewing 40 Australian principals. By combining qualitative case studies with probabilistic measurement techniques, the alternative approach provides contextually rich descriptions of growth in performance…

A Systematic Knowledge Management Approach Using Object-Oriented Theory in Customer Complaint Management

Directory of Open Access Journals (Sweden)

Wusheng Zhang

2010-12-01

Full Text Available Research into the effectiveness of customer complaint management has attracted researchers, yet there has been little discussion on customer complaint management in the context of systematic knowledge management approach particularly in the domain of hotel industry. This paper aims to address such gap through the application of object-oriented theory for which the notation of unified modelling language has been adopted for the representation of the concepts, objects, relationships and vocabularies in the domain. The paper used data from forty seven hotel management staff and academics in hospitalitymanagement to investigate lessons learned and best practices in customer complaint management and knowledge management. By providing insights into the potential of a knowledge management approach using object oriented theory, this study advances our understanding on how a knowledge management approach can systematically support the management of hotel customer complaints.

Systematic Approach to Calculate the Concentration of Chemical Species in Multi-Equilibrium Problems

Science.gov (United States)

Baeza-Baeza, Juan Jose; Garcia-Alvarez-Coque, Maria Celia

2011-01-01

A general systematic approach is proposed for the numerical calculation of multi-equilibrium problems. The approach involves several steps: (i) the establishment of balances involving the chemical species in solution (e.g., mass balances, charge balance, and stoichiometric balance for the reaction products), (ii) the selection of the unknowns (the…

Upper limit for Poisson variable incorporating systematic uncertainties by Bayesian approach

International Nuclear Information System (INIS)

Zhu, Yongsheng

2007-01-01

To calculate the upper limit for the Poisson observable at given confidence level with inclusion of systematic uncertainties in background expectation and signal efficiency, formulations have been established along the line of Bayesian approach. A FORTRAN program, BPULE, has been developed to implement the upper limit calculation

Training in ionizing radiation metrology: a systematic approach

International Nuclear Information System (INIS)

Peixoto, J.G.P.; Sales, E.; Wieland, P.

2001-01-01

This paper presents the systematic approach to training applied to the determination of backscattering factor of the mammography radiation qualities implemented at LNMRI/IRD/CNEN. The strategy for training includes the procedures described at the IAEA Safety Reports Series 201, i.e. analysis, design, implementation and evaluation with feedback . The training included theoretical and practical classes on dosimetry tools, interaction of radiation with matter, radiation protection, laboratory rules, and measurements and uncertainty analysis. At the end the trainee presents a seminar to show the competency acquired and to improve the scientific communication skills. (author)

Calculation of the detection limit in radiation measurements with systematic uncertainties

International Nuclear Information System (INIS)

Kirkpatrick, J.M.; Russ, W.; Venkataraman, R.; Young, B.M.

2015-01-01

The detection limit (L D ) or Minimum Detectable Activity (MDA) is an a priori evaluation of assay sensitivity intended to quantify the suitability of an instrument or measurement arrangement for the needs of a given application. Traditional approaches as pioneered by Currie rely on Gaussian approximations to yield simple, closed-form solutions, and neglect the effects of systematic uncertainties in the instrument calibration. These approximations are applicable over a wide range of applications, but are of limited use in low-count applications, when high confidence values are required, or when systematic uncertainties are significant. One proposed modification to the Currie formulation attempts account for systematic uncertainties within a Gaussian framework. We have previously shown that this approach results in an approximation formula that works best only for small values of the relative systematic uncertainty, for which the modification of Currie's method is the least necessary, and that it significantly overestimates the detection limit or gives infinite or otherwise non-physical results for larger systematic uncertainties where such a correction would be the most useful. We have developed an alternative approach for calculating detection limits based on realistic statistical modeling of the counting distributions which accurately represents statistical and systematic uncertainties. Instead of a closed form solution, numerical and iterative methods are used to evaluate the result. Accurate detection limits can be obtained by this method for the general case

CONCEPTUAL DIMENSION OF SYSTEMATIC APPROACH TO THE ORGANIZATION MANAGEMENT

Directory of Open Access Journals (Sweden)

Eduard Maltsev

2016-06-01

Full Text Available Purpose: The systematic representation of the individual and the organization at the conceptual level is a powerful tool to understand and design an organization as a whole. The systematic approach called to deal to the complexity of modern organizations while the use of abstraction let properly represent the relationships in the system. There are not too many attempts to combine the conceptual representation of organization and a person in the organization. Methods: We formulate a cross-cutting logic of creating links between personal and organizational concepts in the systematic approach to strategic management. It is shown that such representation is possible in the same conceptual frame: description, values, goals, mechanisms. The logic let ensure the clearness in providing integrity of the organization at the conceptual level and therefore influence people's behaviour at work in a direction desired for the whole system. Results: It is shown that the use of a conceptual frame allows to describe an organization through the substrate (Self-concepts of employees, concept (creating value for stakeholders and relationships (embeddedness of the concept into the substrate –Self-concepts of employees. Suggested cross-cutting logic let establish the links between personal and organizational concepts.  The core in the logic is correct representation of the organization and a person at conceptual level. Discussion: The definition of the Self-concept of each employee in the same conceptual frame is not trivial task due to the difficulty of adequate "measuring of oneself", abstraction and self-description in a given frame. Very common, for example, is the discrepancy between perceptions of itself and perception about the person of others. The development of methods of forming linked and holistic conceptual representations of personality and organization is an important topic for future research.

Alternative Forms of Resilience. A typology of approaches for the study of Citizen Collective Responses in Hard Economic Times

Directory of Open Access Journals (Sweden)

Maria Kousis

2017-05-01

Full Text Available A variety of theoretical and conceptual perspectives have been applied to studying collective citizen initiatives arising in response to hard economic times, such as solidarity-based exchanges and networks, cooperative structures, barter clubs, credit unions, ethical banks, time banks, alternative social currency, citizens' self-help groups, neighbourhood assemblies and social enterprises. Since the global financial crisis of 2008, scholarly attention on novel, alternative, resilient structures has increased, especially in regions that have been most affected. A comprehensive literature review is therefore needed on these initiatives which usually aim to meet basic needs such as food, shelter, health and education at the community level, or build and envision autonomous communities. This paper has four aims. First, it proposes a new, all-encompassing conceptual framework, alternative forms of resilience, to embrace all issues and groups related to such initiatives, during the new millennium and its economic and political challenges, while taking into account the impact of the 2008 crisis. Secondly, it offers a comprehensive literature review on collective citizen initiatives studied through different theoretical, methodological and conceptual understandings. Thirdly, it provides a new typology of several approaches on novel, collective and solidarity-oriented critical resilience initiatives which take into account political issues, be they policy or social-movement related. Finally, it points to future research areas which would aim to systematically address the political and non-political features of citizen-collective responses.

Auditing energy use -a systematic approach for enhancing energy efficiency

International Nuclear Information System (INIS)

Ardhapnrkar, P.M.; Mahalle, A.M.

2005-01-01

Energy management is a critical activity in the developing as well as developed countries owing to constraints in the availability of primary energy resources and the increasing demand for energy from the industrial and non-industrial users. Energy consumption is a vital parameter that determines the economic growth of any country. An energy management system (EMS) can save money by allowing greater control over energy consuming equipment. The foundation for the energy program is the energy audit, which is the systematic study of factory or building to determine where and how well energy is being used. It is the nucleus of any successful energy saving program -it is tool, not a solution. Conventional energy conservation methods are mostly sporadic and lack a coordinated plan of action. Consequently only apparent systems are treated without the analysis of system interaction. Energy audit on the other hand, involves total system approach and aims at optimizing energy use efficiently for the entire plant. In the present paper a new approach to pursue energy conservation techniques is being discussed. The focus is mainly on the methodology of energy audit, energy use analysis, relating energy with the production, and reducing energy losses, etc. It is observe that with this systematic approach, if adopted, which consists of three essential segments namely capacity utilization fine-tuning of the equipment and technology up-gradation can result in phenomenal savings in the energy, building competitive edge for the industry. This approach along with commitment can provide the right impetus to reap the benefits of energy conservation on a sustained basis. (author)

Waste management project’s alternatives: A risk-based multi-criteria assessment (RBMCA) approach

International Nuclear Information System (INIS)

Karmperis, Athanasios C.; Sotirchos, Anastasios; Aravossis, Konstantinos; Tatsiopoulos, Ilias P.

2012-01-01

Highlights: ► We examine the evaluation of a waste management project’s alternatives. ► We present a novel risk-based multi-criteria assessment (RBMCA) approach. ► In the RBMCA the evaluation criteria are based on the quantitative risk analysis of the project’s alternatives. ► Correlation between the criteria weight values and the decision makers’ risk preferences is examined. ► Preference to the multi-criteria against the one-criterion evaluation process is discussed. - Abstract: This paper examines the evaluation of a waste management project’s alternatives through a quantitative risk analysis. Cost benefit analysis is a widely used method, in which the investments are mainly assessed through the calculation of their evaluation indicators, namely benefit/cost (B/C) ratios, as well as the quantification of their financial, technical, environmental and social risks. Herein, a novel approach in the form of risk-based multi-criteria assessment (RBMCA) is introduced, which can be used by decision makers, in order to select the optimum alternative of a waste management project. Specifically, decision makers use multiple criteria, which are based on the cumulative probability distribution functions of the alternatives’ B/C ratios. The RBMCA system is used for the evaluation of a waste incineration project’s alternatives, where the correlation between the criteria weight values and the decision makers’ risk preferences is analyzed and useful conclusions are discussed.

Systematic approach to establishing criticality biases

International Nuclear Information System (INIS)

Larson, S.L.

1995-09-01

A systematic approach has been developed to determine benchmark biases and apply those biases to code results to meet the requirements of DOE Order 5480.24 regarding documenting criticality safety margins. Previously, validation of the code against experimental benchmarks to prove reasonable agreement was sufficient. However, DOE Order 5480.24 requires contractors to adhere to the requirements of ANSI/ANS-8.1 and establish subcritical margins. A method was developed to incorporate biases and uncertainties from benchmark calculations into a k eff value with quantifiable uncertainty. The method produces a 95% confidence level in both the k eff value of the scenario modeled and the distribution of the k eff S calculated by the Monte Carlo code. Application of the method to a group of benchmarks modeled using the KENO-Va code and the SCALE 27 group cross sections is also presented

Systematic approach to designing surface covers for uranium-mill tailings

International Nuclear Information System (INIS)

Beedlow, P.A.; Cadwell, L.L.; McShane, M.C.

1982-01-01

The wide range of environmental conditions present at uranium mill tailings sites precludes the use of a single type of surface cover. Surface covers must be designed on a site-specific basis. To facilitate site specific designs the UMTRA program is developing guidelines for designing surface covers. This paper presents a systematic approach to designing surface covers for tailings that can be applied under any site condition. The approach consists of three phases: (1) An assessment during which the degree of surface protection is determined. (2) A preliminary design that facilitates interaction with those designing other containment system elements. (3) A final design where the cost and effectiveness of the surface cover are determined. The types of information required to apply this approach are discussed

A novel reversible logic gate and its systematic approach to implement cost-efficient arithmetic logic circuits using QCA.

Science.gov (United States)

Ahmad, Peer Zahoor; Quadri, S M K; Ahmad, Firdous; Bahar, Ali Newaz; Wani, Ghulam Mohammad; Tantary, Shafiq Maqbool

2017-12-01

Quantum-dot cellular automata, is an extremely small size and a powerless nanotechnology. It is the possible alternative to current CMOS technology. Reversible QCA logic is the most important issue at present time to reduce power losses. This paper presents a novel reversible logic gate called the F-Gate. It is simplest in design and a powerful technique to implement reversible logic. A systematic approach has been used to implement a novel single layer reversible Full-Adder, Full-Subtractor and a Full Adder-Subtractor using the F-Gate. The proposed Full Adder-Subtractor has achieved significant improvements in terms of overall circuit parameters among the most previously cost-efficient designs that exploit the inevitable nano-level issues to perform arithmetic computing. The proposed designs have been authenticated and simulated using QCADesigner tool ver. 2.0.3.

An alternative approach for real-time balancing of electrical power systems

NARCIS (Netherlands)

Virag, A.; Jokic, A.; Lampropoulos, I.; Hermans, R.M.; Bosch, van den P.P.J.

2012-01-01

In this paper, we focus on the inefficiencies of current real-time balancing of power systems and propose an alternative solution. Our approach is based on the introduction of double-sided markets for the provision of secondary control and a market-based provision of primary control. We propose

Systematic approach to training. Experiences from the training activities of regulatory body personnel in STUK

Energy Technology Data Exchange (ETDEWEB)

Aro, I.

1998-04-01

The report describes the experiences obtained of a training programme for nuclear power plant inspectors arranged in the 90`s by the Radiation and Nuclear Safety Authority of Finland (STUK). In the implementation of the programme, a systematic method was used to analyse the training needs, to plan, develop and implement the training programme as well as to assess the programme`s implementation and results. The method used, `SAT Ae Systematic Approach to Training`, is presented in `Nuclear Power Plant Personnel Training and its Evaluation, A Guidebook`, IAEA Technical Report Series No. 380, which is a publication of the International Atomic Energy Agency. It is recommended that this method be applied in the planning and implementation of nuclear power plant personnel training. The application of the method as a tool for developing the qualifications of nuclear power plant inspectors shows that the method is well suited for use in Finland. Until the 90`s, STUK had no systematic approach to training activities. Some training was arranged internally, but training in most respects meant participation in external training events and international seminars. A more systematic approach was adopted in the early 90`s. The main goal was to define basic competence profiles for inspectors working in different fields and to provide an internal basic training programme not available externally. The development of the training activities called for a profound renewal of the training function to ensure a systematic approach and high quality. The experiences gained in STUK are useful in co-operation with Eastern and Central European regulatory bodies; they can be utilized when the qualifications of personnel who carry out inspections are developed. This will extensively contribute to the safety of nuclear power plants. (orig.). 2 refs.

Systematic approach to training. Experiences from the training activities of regulatory body personnel in STUK

International Nuclear Information System (INIS)

Aro, I.

1998-04-01

The report describes the experiences obtained of a training programme for nuclear power plant inspectors arranged in the 90's by the Radiation and Nuclear Safety Authority of Finland (STUK). In the implementation of the programme, a systematic method was used to analyse the training needs, to plan, develop and implement the training programme as well as to assess the programme's implementation and results. The method used, 'SAT Ae Systematic Approach to Training', is presented in 'Nuclear Power Plant Personnel Training and its Evaluation, A Guidebook', IAEA Technical Report Series No. 380, which is a publication of the International Atomic Energy Agency. It is recommended that this method be applied in the planning and implementation of nuclear power plant personnel training. The application of the method as a tool for developing the qualifications of nuclear power plant inspectors shows that the method is well suited for use in Finland. Until the 90's, STUK had no systematic approach to training activities. Some training was arranged internally, but training in most respects meant participation in external training events and international seminars. A more systematic approach was adopted in the early 90's. The main goal was to define basic competence profiles for inspectors working in different fields and to provide an internal basic training programme not available externally. The development of the training activities called for a profound renewal of the training function to ensure a systematic approach and high quality. The experiences gained in STUK are useful in co-operation with Eastern and Central European regulatory bodies; they can be utilized when the qualifications of personnel who carry out inspections are developed. This will extensively contribute to the safety of nuclear power plants. (orig.)

Why should nuclear power plant management support the systematic approach to training?

International Nuclear Information System (INIS)

Haber, S.B.; Yoder, J.A.

1998-01-01

The presentation shows the role of management in training of NPP personnel especially in training for technology transfer and training for transfer of the training capabilities. Systematic approach to training should be used to achieve standard among different industries; consistent, effective and efficient training

Iterative approach as alternative to S-matrix in modal methods

Science.gov (United States)

Semenikhin, Igor; Zanuccoli, Mauro

2014-12-01

The continuously increasing complexity of opto-electronic devices and the rising demands of simulation accuracy lead to the need of solving very large systems of linear equations making iterative methods promising and attractive from the computational point of view with respect to direct methods. In particular, iterative approach potentially enables the reduction of required computational time to solve Maxwell's equations by Eigenmode Expansion algorithms. Regardless of the particular eigenmodes finding method used, the expansion coefficients are computed as a rule by scattering matrix (S-matrix) approach or similar techniques requiring order of M3 operations. In this work we consider alternatives to the S-matrix technique which are based on pure iterative or mixed direct-iterative approaches. The possibility to diminish the impact of M3 -order calculations to overall time and in some cases even to reduce the number of arithmetic operations to M2 by applying iterative techniques are discussed. Numerical results are illustrated to discuss validity and potentiality of the proposed approaches.

Living with a systematic approach to training. A personal experience

International Nuclear Information System (INIS)

Duarte, R.F.

2002-01-01

The Systematic Approach to Training (SAT) plays an important role in the safe operation of a nuclear power plant. It can often be seen as the answer to all training needs but it can sometimes fall victim to its own rigidity and inertia. This paper outlines the personal experiences and conceptual models of a former Human Resources Manager with responsibility for both pre operational and operational training. (author)

A systematic approach for fine-tuning of fuzzy controllers applied to WWTPs

DEFF Research Database (Denmark)

Ruano, M.V.; Ribes, J.; Sin, Gürkan

2010-01-01

A systematic approach for fine-tuning fuzzy controllers has been developed and evaluated for an aeration control system implemented in a WWTR The challenge with the application of fuzzy controllers to WWTPs is simply that they contain many parameters, which need to be adjusted for different WWTP ...

Bottom-up and Top-down: An alternate classification of LD authoring approaches

NARCIS (Netherlands)

Sodhi, Tim; Miao, Yongwu; Brouns, Francis; Koper, Rob

2007-01-01

Sodhi, T., Miao, Y., Brouns, F., & Koper, E. J. R. (2007). Bottom-up and Top-down: An alternate classification of LD authoring approaches. Paper presented at the TENCompetence Open Workshop on Current research on IMS Learning Design and Lifelong Competence Development Infrastructures. June, 21-22,

Corporate finance in an interest free economy: An alternate approach to practiced Islamic Corporate Finance

OpenAIRE

Shaikh, Salman

2009-01-01

This paper suggests an alternate approach to corporate finance in an interest free economy by looking beyond practiced Islamic finance and suggesting alternatives for corporate finance in sourcing funds i.e. i) Ijara with embedded options, ii) limited liability partnership, iii) equity modes like Musharakah and Mudarabah iv) income bonds and v) convertible income bonds. It also suggests alternatives for corporate finance in using funds i.e. i) Islamic income funds, ii) Islamic REITs, iii) Tre...

A Systematic Approach to Discussing Active Surveillance with Patients with Low-risk Prostate Cancer.

Science.gov (United States)

Ehdaie, Behfar; Assel, Melissa; Benfante, Nicole; Malhotra, Deepak; Vickers, Andrew

2017-06-01

Physicians report difficulty convincing patients with prostate cancer about the merits of active surveillance (AS); as a result, a majority of patients unnecessarily choose to undergo radical treatment. To develop and evaluate a systematic approach for physicians to counsel patients with low-risk prostate cancer to increase acceptance of AS. A systematic counseling approach was developed and piloted in one clinic. Then five surgeons participated in a 1-h training session in which they learned about the approach. A total of 1003 patients with Gleason 3+3 prostate cancer were included in the study. We compared AS rates for 761 patients who were counseled over a 24-mo period before the training intervention with AS rates for 242 patients who were counseled over a 12-mo period afterwards, controlling for temporal trends and case mix. A systematic approach for communicating the merits of AS using appropriate framing techniques derived from principles studied by negotiation scholars. The rate of AS acceptance by patients for management of low-risk prostate cancer. In the pilot phase, 81 of 86 patients (94%) accepted AS after counseling by the physician who developed the counseling approach. In the subsequent study, the cohort for the training intervention comprised 1003 consecutive patients, 80% of whom met the Epstein criteria for very low-risk disease. The proportion of patients who selected AS increased from 69% before the training intervention to 81% afterwards. After adjusting for time trends and case mix, the rate of AS after the intervention was 9.1% higher (95% confidence interval -0.4% to 19.4%) than expected, a relative reduction of approximately 30% in the risk of unnecessary curative treatment. A systematic approach to counseling can be taught to physicians in a 1-h lecture. We found evidence that even this minimal intervention can decrease overtreatment. Our novel approach offers a framework to help address cancer screening-related overtreatment that occurs

Systematic Approach to Modernization of the Russian Federal Spatial Development

Directory of Open Access Journals (Sweden)

A. I. Tatarkin

2012-01-01

Full Text Available The paper estimates the regional and municipal opportunities of spa- tial development modernization in the Russian Federation. In the post-crisis period, it is necessary to facilitate the innovative processes and society oriented state develop- ment to give way to the steady transition from the regional policy to the federal state structure, which requires scientifically based decision making in all the directions of social development. The author considers the ideology of such transition and recom- mends using the systematic approach to choosing priorities and development institu- tions. Several perspective factors such as education and science are analyzed in the context of systematic regional and territorial development along with the necessity for program-project modernization of the federal state structure. The following new insti- tutions for regional development are proposed: regional and municipal self-deve- lopment, business territories, program-project planning of spatial development. 

Systematic Approach to Modernization of the Russian Federal Spatial Development

Directory of Open Access Journals (Sweden)

A. I. Tatarkin

2015-01-01

Full Text Available The paper estimates the regional and municipal opportunities of spa- tial development modernization in the Russian Federation. In the post-crisis period, it is necessary to facilitate the innovative processes and society oriented state develop- ment to give way to the steady transition from the regional policy to the federal state structure, which requires scientifically based decision making in all the directions of social development. The author considers the ideology of such transition and recom- mends using the systematic approach to choosing priorities and development institu- tions. Several perspective factors such as education and science are analyzed in the context of systematic regional and territorial development along with the necessity for program-project modernization of the federal state structure. The following new insti- tutions for regional development are proposed: regional and municipal self-deve- lopment, business territories, program-project planning of spatial development. 

A systematic approach to safety case maintenance

International Nuclear Information System (INIS)

Kelly, T.P.; McDermid, J.A.

2001-01-01

A crucial aspect of safety case management is the ongoing maintenance of the safety argument through life. Throughout the operational life of any system, changing regulatory requirements, additional safety evidence and a changing design can challenge the corresponding safety case. In order to maintain an accurate account of the safety of the system, all such challenges must be assessed for their impact on the original safety argument. This is increasingly being recognised by many safety standards. However, many safety engineers are experiencing difficulties with safety case maintenance at present, the prime reason being that they do not have a systematic and methodical approach by which to examine the impact of change on safety argument. The size and complexity of safety arguments and evidence being presented within safety cases is increasing. Nowhere is this more apparent than for Electrical, Electronic and Programmable Electronic systems attempting to comply with the requirements and recommendations of software and hardware safety standards such as and UK Defence Standards 00-54 [MoD. 00-54 Requirements of Safety Related Electronic Hardware in Defence Equipment. Ministry of Defence, Interim Defence Standard, 1999], 00-55 []. However, this increase in safety case complexity exacerbates problems of comprehension and maintainability later on in the system lifecycle. This paper defines and describes a tool-supported process, based upon the principles of goal structuring, that attempts to address these difficulties through facilitating the systematic impact assessment of safety case challenges

Alternative approaches to food: Community supported agriculture in urban China

OpenAIRE

Krul, K.; Ho, P.P.S.

2017-01-01

One of the most remarkable features of China's development path is its large-scale and fast-paced urbanization. As cities already accommodate more than half of China's population, new challenges to urban food systems have emerged concurrently. Concerns over environmental degradation and food safety have provoked growing dissatisfaction with China's food regime. Amidst these concerns, the aim of this paper is to study the role of new and alternative approaches to food, focusing in on the quest...

When and how to recommend 'alternative approaches' in the management of high blood pressure.

Science.gov (United States)

Brook, Robert D; Jackson, Elizabeth A; Giorgini, Paolo; McGowan, Cheri L

2015-06-01

Several nonpharmacologic therapies, such as sodium restriction and weight loss, have been promoted by hypertension guidelines based on the trial evidence supporting their capacity to lower blood pressure. However, many patients may not respond or be able to adhere to these nonpharmacologic treatments. Despite numerous formal diet and lifestyle recommendations, the prevalence of hypertension continues to grow worldwide. As such, additional approaches are needed to help combat this public health epidemic. In this review, we outline the evidence supporting the efficacy of a number of alternative approaches for blood pressure lowering. On the basis of the recommendations by a recent American Heart Association scientific statement, we also provide guidance on when and how to implement these methods in clinical practice. The available evidence supports several approaches, including Transcendental Meditation, device-guided slow breathing, and aerobic, resistance, and isometric exercises. Nonetheless, many questions remain, and future recommendations for using alternative approaches will need to be updated as new trials are published. Copyright © 2015 Elsevier Inc. All rights reserved.

Upgrading NPP personnel. Competence and training through the systematic approach to training

International Nuclear Information System (INIS)

Mautner Markhof, F.

1998-01-01

This paper presents the reasons for acceptance of SAT (Systematic Approach to Training) as the best international practice in respect to training of NPP personnel and the differences in comparison to traditional approaches to training. The identification and evaluation of the new training needs, resources and other requirements for implementing SAT are discussed as well as new approaches and existing training capabilities and involvement of Regulatory body in training of NPP personnel. The IAEA Guidebook on NPP Personnel Training (TRS-380) was used a a basis for discussion of the mentioned topics with the emphasis on achieving the best possible training programmes for NPP personnel

3S - Systematic, systemic, and systems biology and toxicology.

Science.gov (United States)

Smirnova, Lena; Kleinstreuer, Nicole; Corvi, Raffaella; Levchenko, Andre; Fitzpatrick, Suzanne C; Hartung, Thomas

2018-01-01

A biological system is more than the sum of its parts - it accomplishes many functions via synergy. Deconstructing the system down to the molecular mechanism level necessitates the complement of reconstructing functions on all levels, i.e., in our conceptualization of biology and its perturbations, our experimental models and computer modelling. Toxicology contains the somewhat arbitrary subclass "systemic toxicities"; however, there is no relevant toxic insult or general disease that is not systemic. At least inflammation and repair are involved that require coordinated signaling mechanisms across the organism. However, the more body components involved, the greater the challenge to reca-pitulate such toxicities using non-animal models. Here, the shortcomings of current systemic testing and the development of alternative approaches are summarized. We argue that we need a systematic approach to integrating existing knowledge as exemplified by systematic reviews and other evidence-based approaches. Such knowledge can guide us in modelling these systems using bioengineering and virtual computer models, i.e., via systems biology or systems toxicology approaches. Experimental multi-organ-on-chip and microphysiological systems (MPS) provide a more physiological view of the organism, facilitating more comprehensive coverage of systemic toxicities, i.e., the perturbation on organism level, without using substitute organisms (animals). The next challenge is to establish disease models, i.e., micropathophysiological systems (MPPS), to expand their utility to encompass biomedicine. Combining computational and experimental systems approaches and the chal-lenges of validating them are discussed. The suggested 3S approach promises to leverage 21st century technology and systematic thinking to achieve a paradigm change in studying systemic effects.

An alternative approach to contrast-detail testing of X-ray image intensifier systems

International Nuclear Information System (INIS)

Kotre, C.J.; Marshall, N.W.; Faulkner, K.

1992-01-01

The difficulties of making the results of threshold contrast-detail diameter tests on X-ray image intensifier systems consistent with published performance standards are discussed. The current approach to contrast-detail testing is described and an alternative method intended to give greater consistency for all image intensifier input field diameters proposed. The current and alternative test conditions are compared on two image intensifier systems. The results obtained show that the contrast-detail curves for image intensifier systems with a wide range of input field diameters can be effectively normalized to be directly comparable to a common reference standard by applying the proposed alternative test conditions. The implications of this result on the interpretation of the contrast-detail test are discussed. (author)

A Systematic Approach for Real-Time Operator Functional State Assessment

Science.gov (United States)

Zhang, Guangfan; Wang, Wei; Pepe, Aaron; Xu, Roger; Schnell, Thomas; Anderson, Nick; Heitkamp, Dean; Li, Jiang; Li, Feng; McKenzie, Frederick

2012-01-01

A task overload condition often leads to high stress for an operator, causing performance degradation and possibly disastrous consequences. Just as dangerous, with automated flight systems, an operator may experience a task underload condition (during the en-route flight phase, for example), becoming easily bored and finding it difficult to maintain sustained attention. When an unexpected event occurs, either internal or external to the automated system, the disengaged operator may neglect, misunderstand, or respond slowly/inappropriately to the situation. In this paper, we discuss an approach for Operator Functional State (OFS) monitoring in a typical aviation environment. A systematic ground truth finding procedure has been designed based on subjective evaluations, performance measures, and strong physiological indicators. The derived OFS ground truth is continuous in time compared to a very sparse estimation of OFS based on an expert review or subjective evaluations. It can capture the variations of OFS during a mission to better guide through the training process of the OFS assessment model. Furthermore, an OFS assessment model framework based on advanced machine learning techniques was designed and the systematic approach was then verified and validated with experimental data collected in a high fidelity Boeing 737 simulator. Preliminary results show highly accurate engagement/disengagement detection making it suitable for real-time applications to assess pilot engagement.

The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews

Directory of Open Access Journals (Sweden)

Kumar S

2013-09-01

Full Text Available Saravana Kumar,1 Kate Beaton,1 Tricia Hughes2 1International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia; 2Australian Association of Massage Therapists, Adelaide, South Australia, Australia Introduction: The last decade has seen a growth in the utilization of complementary and alternative medicine therapies, and one of the most popular and sought-after complementary and alternative medicine therapies for nonspecific low back pain is massage. Massage may often be perceived as a safe therapeutic modality without any significant risks or side effects. However, despite its popularity, there continues to be ongoing debate on the effectiveness of massage in treating nonspecific low back pain. With a rapidly evolving research evidence base and access to innovative means of synthesizing evidence, it is time to reinvestigate this issue. Methods: A systematic, step-by-step approach, underpinned by best practice in reviewing the literature, was utilized as part of the methodology of this umbrella review. A systematic search was conducted in the following databases: Embase, MEDLINE, AMED, ICONDA, Academic Search Premier, Australia/New Zealand Reference Centre, CINAHL, HealthSource, SPORTDiscus, PubMed, The Cochrane Library, Scopus, Web of Knowledge/Web of Science, PsycINFO, and ProQuest Nursing and Allied Health Source, investigating systematic reviews and meta-analyses from January 2000 to December 2012, and restricted to English-language documents. Methodological quality of included reviews was undertaken using the Centre for Evidence Based Medicine critical appraisal tool. Results: Nine systematic reviews were found. The methodological quality of the systematic reviews varied (from poor to excellent although, overall, the primary research informing these systematic reviews was generally considered to be weak quality. The findings indicate that massage may be an

The Primordial Soup Algorithm : a systematic approach to the specification of parallel parsers

NARCIS (Netherlands)

Janssen, Wil; Janssen, W.P.M.; Poel, Mannes; Sikkel, Nicolaas; Zwiers, Jakob

1992-01-01

A general framework for parallel parsing is presented, which allows for a unitied, systematic approach to parallel parsing. The Primordial Soup Algorithm creates trees by allowing partial parse trees to combine arbitrarily. By adding constraints to the general algorithm, a large, class of parallel

Pattern Recognition Approaches for Breast Cancer DCE-MRI Classification: A Systematic Review.

Science.gov (United States)

Fusco, Roberta; Sansone, Mario; Filice, Salvatore; Carone, Guglielmo; Amato, Daniela Maria; Sansone, Carlo; Petrillo, Antonella

2016-01-01

We performed a systematic review of several pattern analysis approaches for classifying breast lesions using dynamic, morphological, and textural features in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Several machine learning approaches, namely artificial neural networks (ANN), support vector machines (SVM), linear discriminant analysis (LDA), tree-based classifiers (TC), and Bayesian classifiers (BC), and features used for classification are described. The findings of a systematic review of 26 studies are presented. The sensitivity and specificity are respectively 91 and 83 % for ANN, 85 and 82 % for SVM, 96 and 85 % for LDA, 92 and 87 % for TC, and 82 and 85 % for BC. The sensitivity and specificity are respectively 82 and 74 % for dynamic features, 93 and 60 % for morphological features, 88 and 81 % for textural features, 95 and 86 % for a combination of dynamic and morphological features, and 88 and 84 % for a combination of dynamic, morphological, and other features. LDA and TC have the best performance. A combination of dynamic and morphological features gives the best performance.

A systematic approach to the interpretation of preoperative staging MRI for rectal cancer.

Science.gov (United States)

Taylor, Fiona G M; Swift, Robert I; Blomqvist, Lennart; Brown, Gina

2008-12-01

The purpose of this article is to provide an aid to the systematic evaluation of MRI in staging rectal cancer. MRI has been shown to be an effective tool for the accurate preoperative staging of rectal cancer. In the Magnetic Resonance Imaging and Rectal Cancer European Equivalence Study (MERCURY), imaging workshops were held for participating radiologists to ensure standardization of scan acquisition techniques and interpretation of the images. In this article, we report how the information was obtained and give examples of the images and how they are interpreted, with the aim of providing a systematic approach to the reporting process.

Vowel quality alternation in Dinka verb derivation

DEFF Research Database (Denmark)

Andersen, Torben

2017-01-01

In Dinka, a predominantly monosyllabic and highly fusional Western Nilotic language, vowel quality alternation in the root plays a major and systematic role in the morphology of verbs, together with alternations in vowel length, voice quality, and tone. Earlier work has shown that in the inflecti...... modifications. These include a different distribution of the vowel grades and interaction with a shift in voice quality, to breathy voice.......In Dinka, a predominantly monosyllabic and highly fusional Western Nilotic language, vowel quality alternation in the root plays a major and systematic role in the morphology of verbs, together with alternations in vowel length, voice quality, and tone. Earlier work has shown that in the inflection...... of simple, i. e., underived, transitive verbs, the vowel quality alternation conforms to a vowel height gradation system with three vowel grades. The present article shows that this vowel gradation system is also operative in the morphology of derived verbs with a transitive root, but with certain...

Risk as economic category: systematics scientific approach and refinement contents

OpenAIRE

V.G. Vygovskyy

2015-01-01

The paper studies the categorical-conceptual apparatus of risk and its refinement based on a critical analysis of existing systematic scientific approaches. Determined that in the refinement of the economic nature of the risk of a number of controversial issues: the definition of the objective or subjective nature of risk; matching of concepts such as «risk», «danger», «loss», «probability of loss»; definition of negative or positive consequences of risk; identification of risk with its conse...

Flaw tolerance as an alternative approach for operating plant fatigue evaluation

International Nuclear Information System (INIS)

Deardorff, A.F.; Riccardella, P.C.

1994-01-01

In the design of Class 1 components for nuclear reactors, the ASME Boiler and Pressure Vessel Code requires that the suitability for cyclic operation be addressed to assure a fatigue-resistant design. During plant operation, the acceptability of the component may come in to question if new types of loading conditions are identified or if the number of plant cycles exceeds that considered in the original design. The most common approach for addressing this issue is by performing a revised fatigue evaluation, consistent with that considered in the original design. This paper presents an alternative approach for demonstrating acceptability for continued service using concepts from fracture mechanics

Systematic approach to characterisation of NORM in Thailand

International Nuclear Information System (INIS)

Chanyotha, S.; Kranrod, C.; Pengvanich, P.

2015-01-01

The aim of this article is to provide information on the systematic approach that has been developed for the measurement of natural radiation exposure and the characterisation of naturally occurring radioactive materials (NORM) in terms of occurrence and distribution in various industrial processes, including the produced waste from the mineral industries in Thailand. The approach can be adapted for various types of study areas. The importance of collaboration among research institutions is discussed. Some developments include 25 documents; the redesign of the field equipment, such as the gamma survey meter, for convenient access to conduct measurement in various study areas; the method to collect and analyse radon gas from a natural gas pipeline and the manganese dioxide fibre to adsorb radium on-site for laboratory analysis. The NORM project in Thailand has been carried out for more than 10 y to support the development of NORM regulation in Thailand. In the previous studies as well as current, international standards for action levels have been adopted for safety purpose. (authors)

A practical, systematic and structured approach to piping vibration assessment

International Nuclear Information System (INIS)

Sukaih, Naren

2002-01-01

The main aim of this paper is to present a systematic and structured approach to piping vibration assessment and control. Piping vibration assessment is a complex subject, since there are no general analytical methods for dealing with vibration problems. It was noted that most existing vibrating piping systems had poor or degraded support arrangements. This approach therefore focuses mainly on vibration control through assessing and improving the supporting systems. Vibration theory has not been covered in any detail. A simplified procedure is presented for the Integrity custodian to determine when a simple assessment may be carried out and when specialist/consultant services are required. The assessment techniques are based on simplifying assumptions, good rules of thumb and available literature and current practices. A typical case study is used to illustrate the use and the flexibility of the above approach. A standard sheet is proposed to record and document the assessment and recommendations

Transaortic TAVI Is a Valid Alternative to Transapical Approach.

Science.gov (United States)

O' Sullivan, Katie E; Hurley, Eoghan T; Segurado, Ricardo; Sugrue, Declan; Hurley, John P

2015-05-01

Transcatheter aortic valve implantation (TAVI) can be performed via a number of different anatomical approaches based on patient characteristics and operator choice. The aim of this study was to compare procedural outcomes between transaortic (TAo) and transapical (TA) approaches in an effort to establish whether any differences exist. A systematic review and meta-analysis of the current literature reporting outcomes for patients undergoing TAo and TA TAVI was performed to compare outcomes using each vascular approach to valve deployment. A total of 10 studies and 1736 patients were included. A total of 193 patients underwent TAo and 1543 TA TAVI. No significant difference in 30-day mortality was identified (TAo 9.4, TA 10.4 p = 0.7). There were no significant differences identified between TAo and TA TAVI in procedural success rate (96.3% vs. 93.7% p = 0.3), stroke and transient ischemic attack (TIA) incidence (1.8% vs. 2.3% p = 0.7), major bleed (5.8% vs. 5.5% p = 0.97) or pacemaker insertion rates (6.1% vs. 7.4% p = 0.56). In addition, the incidence of clinically significant paravalvular regurgitation (PVR) was the same between groups (6.7% vs. 11% p = 0.43). Comparison of TAo and TA approaches revealed equivalent outcomes in 30-day mortality, procedural success, major bleeding, stroke/TIA incidence, pacemaker insertion rates and paravalvular leak. Heart teams should be familiar with the use of both TA and TAo access and tailor their selection on a case-to-case basis. © 2015 Wiley Periodicals, Inc.

SustainPro - A tool for systematic process analysis, generation and evaluation of sustainable design alternatives

DEFF Research Database (Denmark)

Carvalho, Ana; Matos, Henrique A.; Gani, Rafiqul

2013-01-01

the user through the necessary steps according to work-flow of the implemented methodology. At the end the design alternatives, are evaluated using environmental impact assessment tools and safety indices. The extended features of the methodology incorporate Life Cycle Assessment analysis and economic....... The software tool is based on the implementation of an extended systematic methodology for sustainable process design (Carvalho et al. 2008 and Carvalho et al. 2009). Using process information/data such as the process flowsheet, the associated mass / energy balance data and the cost data, SustainPro guides...... analysis. The application and the main features of SustainPro are illustrated through a case study of ß-Galactosidase production....

Alternative Approaches to Technical Efficiency Estimation in the Stochastic Frontier Model

OpenAIRE

Acquah, H. de-Graft; Onumah, E. E.

2014-01-01

Estimating the stochastic frontier model and calculating technical efficiency of decision making units are of great importance in applied production economic works. This paper estimates technical efficiency from the stochastic frontier model using Jondrow, and Battese and Coelli approaches. In order to compare alternative methods, simulated data with sample sizes of 60 and 200 are generated from stochastic frontier model commonly applied to agricultural firms. Simulated data is employed to co...

HESI pilot project: Testing a qualitative approach for incorporating exposure into alternatives assessment

DEFF Research Database (Denmark)

Greggs, Bill; Arnold, Scott; Burns, Thomas J.

-quantitative exposure assessment on the alternatives being considered. This talk will demonstrate an approach for including chemical and product exposure information in a qualitative AA comparison. Starting from existing hazard AAs, a series of four exposure examples were examined to test the concept, to understand...

Risks in surgery-first orthognathic approach: complications of segmental osteotomies of the jaws. A systematic review.

Science.gov (United States)

Pelo, S; Saponaro, G; Patini, R; Staderini, E; Giordano, A; Gasparini, G; Garagiola, U; Azzuni, C; Cordaro, M; Foresta, E; Moro, A

2017-01-01

To date, no systematic review has been undertaken to identify the complications of segmental osteotomies. The aim of the present systematic review was to analyze the type and incidence of complications of segmental osteotomies, as well as the time of subjective and/or clinical onset of the intra- and post-operative problems. A search was conducted in two electronic databases (MEDLINE - Pubmed database and Scopus) for articles published in English between 1 January 2000 and 30 August 2015; only human studies were selected. Case report studies were excluded. Two independent researchers selected the studies and extracted the data. Two studies were selected, four additional publications were recovered from the bibliography search of the selected articles, and one additional article was added through a manual search. The results of this systematic review demonstrate a relatively low rate of complications in segmental osteotomies, suggesting this surgical approach is safe and reliable in routine orthognathic surgery. Due to the small number of studies included in this systematic review, the rate of complication related to surgery first approach may be slightly higher than those associated with traditional orthognathic surgery, since the rate of complications of segmental osteotomies must be added to the complication rate of basal osteotomies. A surgery-first approach could be considered riskier than a traditional one, but further studies that include a greater number of subjects should be conducted to confirm these findings.

Bantam: A Systematic Approach to Reusable Launch Vehicle Technology Development

Science.gov (United States)

Griner, Carolyn; Lyles, Garry

1999-01-01

The Bantam technology project is focused on providing a low cost launch capability for very small (100 kilogram) NASA and University science payloads. The cost goal has been set at one million dollars per launch. The Bantam project, however, represents much more than a small payload launch capability. Bantam represents a unique, systematic approach to reusable launch vehicle technology development. This technology maturation approach will enable future highly reusable launch concepts in any payload class. These launch vehicle concepts of the future could deliver payloads for hundreds of dollars per pound, enabling dramatic growth in civil and commercial space enterprise. The National Aeronautics and Space Administration (NASA) has demonstrated a better, faster, and cheaper approach to science discovery in recent years. This approach is exemplified by the successful Mars Exploration Program lead by the Jet Propulsion Laboratory (JPL) for the NASA Space Science Enterprise. The Bantam project represents an approach to space transportation technology maturation that is very similar to the Mars Exploration Program. The NASA Advanced Space Transportation Program (ASTP) and Future X Pathfinder Program will combine to systematically mature reusable space transportation technology from low technology readiness to system level flight demonstration. New reusable space transportation capability will be demonstrated at a small (Bantam) scale approximately every two years. Each flight demonstration will build on the knowledge derived from the previous flight tests. The Bantam scale flight demonstrations will begin with the flights of the X-34. The X-34 will demonstrate reusable launch vehicle technologies including; flight regimes up to Mach 8 and 250,000 feet, autonomous flight operations, all weather operations, twenty-five flights in one year with a surge capability of two flights in less than twenty-four hours and safe abort. The Bantam project will build on this initial

An Alternative Educational Approach for an Inorganic Chemistry Laboratory Course in Industrial and Chemical Engineering

Science.gov (United States)

Garces, Andres; Sanchez-Barba, Luis Fernando

2011-01-01

We describe an alternative educational approach for an inorganic chemistry laboratory module named "Experimentation in Chemistry", which is included in Industrial Engineering and Chemical Engineering courses. The main aims of the new approach were to reduce the high levels of failure and dropout on the module and to make the content match the…

Sistematização de Normas Regulatórias: uma abordagem baseada no neo-institucionalismo / Systematizing Regulations: An Approach Focused on Neo-Institutionalism

Directory of Open Access Journals (Sweden)

João Alberto de Oliveira Lima

2016-05-01

Full Text Available Purpose – This paper proposes an approach based on neo-institutionalism to assist regulations systematization activity. Methodology/approach/design – Interdisciplinary bibliographic research in Philosophy of Language, Information Science and Law. Findings – The neo-institutionalism, mainly in the form proposed by Dick Ruiter, offers a conceptual framework that can assist in systematizing regulations. Practical implications – This article proposes an approach to the systematization of regulations that, despite its importance to the simplification of the legal system and to the legal certainty, has not been executed as required by law. Originality/value – The originality of the proposed approach lies in the combination of concepts and theories from Philosophy of Language, Information Science and Law, as a way to deal with the problem of regulations systematization.

Defining ‘sensitive’ health status: a systematic approach using health code terminologies.

Directory of Open Access Journals (Sweden)

Andy Boyd

2017-04-01

We have demonstrated a systematic and partially interoperable approach to defining ‘sensitive’ health information. However, any such exercise is likely to include decisions which will be open to interpretation and open to change over time. As such, the application of this technique should be embedded within an appropriate governance framework which can accommodate misclassification while minimising potential patient harm.

Variable system: An alternative approach for the analysis of mediated moderation.

Science.gov (United States)

Kwan, Joyce Lok Yin; Chan, Wai

2018-06-01

Mediated moderation (meMO) occurs when the moderation effect of the moderator (W) on the relationship between the independent variable (X) and the dependent variable (Y) is transmitted through a mediator (M). To examine this process empirically, 2 different model specifications (Type I meMO and Type II meMO) have been proposed in the literature. However, both specifications are found to be problematic, either conceptually or statistically. For example, it can be shown that each type of meMO model is statistically equivalent to a particular form of moderated mediation (moME), another process that examines the condition when the indirect effect from X to Y through M varies as a function of W. Consequently, it is difficult for one to differentiate these 2 processes mathematically. This study therefore has 2 objectives. First, we attempt to differentiate moME and meMO by proposing an alternative specification for meMO. Conceptually, this alternative specification is intuitively meaningful and interpretable, and, statistically, it offers meMO a unique representation that is no longer identical to its moME counterpart. Second, using structural equation modeling, we propose an integrated approach for the analysis of meMO as well as for other general types of conditional path models. VS, a computer software program that implements the proposed approach, has been developed to facilitate the analysis of conditional path models for applied researchers. Real examples are considered to illustrate how the proposed approach works in practice and to compare its performance against the traditional methods. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Sensitivity Analysis and Optimization of the Nuclear Fuel Cycle: A Systematic Approach

Science.gov (United States)

Passerini, Stefano

For decades, nuclear energy development was based on the expectation that recycling of the fissionable materials in the used fuel from today's light water reactors into advanced (fast) reactors would be implemented as soon as technically feasible in order to extend the nuclear fuel resources. More recently, arguments have been made for deployment of fast reactors in order to reduce the amount of higher actinides, hence the longevity of radioactivity, in the materials destined to a geologic repository. The cost of the fast reactors, together with concerns about the proliferation of the technology of extraction of plutonium from used LWR fuel as well as the large investments in construction of reprocessing facilities have been the basis for arguments to defer the introduction of recycling technologies in many countries including the US. In this thesis, the impacts of alternative reactor technologies on the fuel cycle are assessed. Additionally, metrics to characterize the fuel cycles and systematic approaches to using them to optimize the fuel cycle are presented. The fuel cycle options of the 2010 MIT fuel cycle study are re-examined in light of the expected slower rate of growth in nuclear energy today, using the CAFCA (Code for Advanced Fuel Cycle Analysis). The Once Through Cycle (OTC) is considered as the base-line case, while advanced technologies with fuel recycling characterize the alternative fuel cycle options available in the future. The options include limited recycling in L WRs and full recycling in fast reactors and in high conversion LWRs. Fast reactor technologies studied include both oxide and metal fueled reactors. Additional fuel cycle scenarios presented for the first time in this work assume the deployment of innovative recycling reactor technologies such as the Reduced Moderation Boiling Water Reactors and Uranium-235 initiated Fast Reactors. A sensitivity study focused on system and technology parameters of interest has been conducted to test

Enabling Reuse of Documentation in New Medical Device Development: A Systematic Architecting Approach

DEFF Research Database (Denmark)

Jensen, Troels Victor; Parslov, Jakob Filippson; Mortensen, Niels Henrik

2015-01-01

presented in this paper are based on a two-year empirical case study of a European manufacturer of arterial blood gas (ABG) sampling devices. The core contribution of this paper is a systematic architecting approach that applies the concept of a delta-multi-domain matrix (ΔMDM) to support companies...

Systematic design approach of fuzzy PID stabilizer for DC-DC converters

International Nuclear Information System (INIS)

Guesmi, K.; Essounbouli, N.; Hamzaoui, A.

2008-01-01

DC-DC converters process electrical energy by switching between a fixed number of configurations. The objective of controlling these systems is to provide better performances, ensure closed loop stability and guarantee a simple predictable behaviour. Based on a converter averaged model, we propose, in this paper, a systematic design approach of a fuzzy PID. The choice of controller parameters stands on the whole system stability requirements. Extension of the obtained asymptotic stability to structural stability is presented to show that the developed controller ensures also a simple and predictable behaviour of the converter. Finally, we illustrate the efficiency of the proposed fuzzy PID design approach through simulations in voltage mode as well as in current mode control

Systematic design approach of fuzzy PID stabilizer for DC-DC converters

Energy Technology Data Exchange (ETDEWEB)

Guesmi, K.; Essounbouli, N.; Hamzaoui, A. [CReSTIC, IUT de Troyes 09, rue de Quebec BP. 396, 10026 Troyes (France)

2008-10-15

DC-DC converters process electrical energy by switching between a fixed number of configurations. The objective of controlling these systems is to provide better performances, ensure closed loop stability and guarantee a simple predictable behaviour. Based on a converter averaged model, we propose, in this paper, a systematic design approach of a fuzzy PID. The choice of controller parameters stands on the whole system stability requirements. Extension of the obtained asymptotic stability to structural stability is presented to show that the developed controller ensures also a simple and predictable behaviour of the converter. Finally, we illustrate the efficiency of the proposed fuzzy PID design approach through simulations in voltage mode as well as in current mode control. (author)

The Psychology Department Model Advisement Procedure: A Comprehensive, Systematic Approach to Career Development Advisement

Science.gov (United States)

Howell-Carter, Marya; Nieman-Gonder, Jennifer; Pellegrino, Jennifer; Catapano, Brittani; Hutzel, Kimberly

2016-01-01

The MAP (Model Advisement Procedure) is a comprehensive, systematic approach to developmental student advisement. The MAP was implemented to improve advisement consistency, improve student preparation for internships/senior projects, increase career exploration, reduce career uncertainty, and, ultimately, improve student satisfaction with the…

A systematic approach for future solid waste cleanup activities at the Hanford Site

International Nuclear Information System (INIS)

Dirks, L.L.; Konynenbelt, H.S.; Hladek, K.L.

1995-02-01

This paper describes the systematic approach to the treatment, storage, and disposal system (TSD) planning and management that has been developed and implemented by Hanford's Solid Waste Program. The systematic approach includes: collecting the forecast and waste inventory data; defining Hanford's TSD system; studying and refining the TSD system by using analysis tools; and documenting analysis results. The customers responsible for planning, funding, and managing future solid waste activities have driven the evolution of the solid waste system. Currently, all treatment facilities are several years from operating. As these facilities become closer to reality, more detailed systems analysis and modeling will be necessary to successfully remediate solid waste at the Site. The tools will continue to be developed in detail to address the complexities of the system as they become better defined. The tools will help determine which facility lay-outs are most optimal, will help determine what types of equipment should be used to optimize the transport of materials to and from each TSD facility, and will be used for performing life-cycle analysis. It is envisioned that in addition to developing the tools to be adapted to the more specific facility design issues, this approach will also be used as an example for other waste installations across the DOE complex

The systematization of practice

DEFF Research Database (Denmark)

Vidal, Rene Victor Valqui

2002-01-01

this paper presents an approach for the systematization of practical experiences whitin Operations Research, Community work, Systems Sciences, Action Research, etc. A case study is presented: the systematization of the activities of a development center in Denmark.......this paper presents an approach for the systematization of practical experiences whitin Operations Research, Community work, Systems Sciences, Action Research, etc. A case study is presented: the systematization of the activities of a development center in Denmark....

Systematic approach to characterisation of NORM in Thailand.

Science.gov (United States)

Chanyotha, S; Kranrod, C; Pengvanich, P

2015-11-01

The aim of this article is to provide information on the systematic approach that has been developed for the measurement of natural radiation exposure and the characterisation of naturally occurring radioactive materials (NORM) in terms of occurrence and distribution in various industrial processes, including the produced waste from the mineral industries in Thailand. The approach can be adapted for various types of study areas. The importance of collaboration among research institutions is discussed. Some developments include 25 documents; the redesign of the field equipment, such as the gamma survey meter, for convenient access to conduct measurement in various study areas; the method to collect and analyse radon gas from a natural gas pipeline and the manganese dioxide fibre to adsorb radium on-site for laboratory analysis. The NORM project in Thailand has been carried out for more than 10 y to support the development of NORM regulation in Thailand. In the previous studies as well as current, international standards for action levels have been adopted for safety purpose. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews.

Science.gov (United States)

Kumar, Saravana; Beaton, Kate; Hughes, Tricia

2013-09-04

The last decade has seen a growth in the utilization of complementary and alternative medicine therapies, and one of the most popular and sought-after complementary and alternative medicine therapies for nonspecific low back pain is massage. Massage may often be perceived as a safe therapeutic modality without any significant risks or side effects. However, despite its popularity, there continues to be ongoing debate on the effectiveness of massage in treating nonspecific low back pain. With a rapidly evolving research evidence base and access to innovative means of synthesizing evidence, it is time to reinvestigate this issue. A systematic, step-by-step approach, underpinned by best practice in reviewing the literature, was utilized as part of the methodology of this umbrella review. A systematic search was conducted in the following databases: Embase, MEDLINE, AMED, ICONDA, Academic Search Premier, Australia/New Zealand Reference Centre, CINAHL, HealthSource, SPORTDiscus, PubMed, The Cochrane Library, Scopus, Web of Knowledge/Web of Science, PsycINFO, and ProQuest Nursing and Allied Health Source, investigating systematic reviews and meta-analyses from January 2000 to December 2012, and restricted to English-language documents. Methodological quality of included reviews was undertaken using the Centre for Evidence Based Medicine critical appraisal tool. Nine systematic reviews were found. The methodological quality of the systematic reviews varied (from poor to excellent) although, overall, the primary research informing these systematic reviews was generally considered to be weak quality. The findings indicate that massage may be an effective treatment option when compared to placebo and some active treatment options (such as relaxation), especially in the short term. There is conflicting and contradictory findings for the effectiveness of massage therapy for the treatment of nonspecific low back pain when compared against other manual therapies (such as

Complementary and alternative medicine for rheumatic diseases: A systematic review of randomized controlled trials.

Science.gov (United States)

Phang, Jie Kie; Kwan, Yu Heng; Goh, Hendra; Tan, Victoria Ie Ching; Thumboo, Julian; Østbye, Truls; Fong, Warren

2018-04-01

To summarize all good quality randomized controlled trials (RCTs) using complementary and alternative medicine (CAM) interventions in patients with rheumatic diseases. A systematic literature review guided by the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) was performed. We excluded non-English language articles and abstract-only publications. Due to the large number of RCTs identified, we only include "good quality" RCTs with Jadad score of five. We identified 60 good quality RCTs using CAM as intervention for patients with rheumatic diseases: acupuncture (9), Ayurvedic treatment (3), homeopathic treatment (3), electricity (2), natural products (31), megavitamin therapies (8), chiropractic or osteopathic manipulation (3), and energy healing therapy (1). The studies do not seem to suggest a particular type of CAM is effective for all types for rheumatic diseases. However, some CAM interventions appear to be more effective for certain types of rheumatic diseases. Acupuncture appears to be beneficial for osteoarthritis but not rheumatoid arthritis. For the other therapeutic modalities, the evidence base either contains too few trials or contains trials with contradictory findings which preclude any definitive summary. There were only minor adverse reactions observed for CAM interventions presented. We identified 60 good quality RCTs which were heterogenous in terms of interventions, disease, measures used to assess outcomes, and efficacy of CAM interventions. Evidence indicates that some CAM therapies may be useful for rheumatic diseases, such as acupuncture for osteoarthritis. Further research with larger sample size is required for more conclusive evidence regarding efficacy of CAM interventions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Complementary and alternative medicine in cancer pain management: A systematic review

Directory of Open Access Journals (Sweden)

Priyanka Singh

2015-01-01

Full Text Available Quality of life (QoL encompasses the physical, psychosocial, social and spiritual dimensions of life lived by a person. Cancer pain is one of the physical component has tremendous impact on the QoL of the patient. Cancer pain is multifaceted and complex to understand and managing cancer pain involves a tool box full of pharmacological and non pharmacological interventions but still there are 50-70% of cancer patients who suffer from uncontrolled pain and they fear pain more than death. Aggressive surgeries, radiotherapy and chemotherapy focus more on prolonging the survival of the patient failing to realize that the QoL lived also matters equally. This paper reviews complementary and alternative therapy approaches for cancer pain and its impact in improving the QoL of cancer patients.

Using a Systematic Approach and Theoretical Framework to Design a Curriculum for the Shaping Healthy Choices Program.

Science.gov (United States)

Linnell, Jessica D; Zidenberg-Cherr, Sheri; Briggs, Marilyn; Scherr, Rachel E; Brian, Kelley M; Hillhouse, Carol; Smith, Martin H

2016-01-01

To examine the use of a systematic approach and theoretical framework to develop an inquiry-based, garden-enhanced nutrition curriculum for the Shaping Healthy Choices Program. Curriculum development occurred in 3 steps: identification of learning objectives, determination of evidence of learning, and activity development. Curriculum activities were further refined through pilot-testing, which was conducted in 2 phases. Formative data collected during pilot-testing resulted in improvements to activities. Using a systematic, iterative process resulted in a curriculum called Discovering Healthy Choices, which has a strong foundation in Social Cognitive Theory and constructivist learning theory. Furthermore, the Backward Design method provided the design team with a systematic approach to ensure activities addressed targeted learning objectives and overall Shaping Healthy Choices Program goals. The process by which a nutrition curriculum is developed may have a direct effect on student outcomes. Processes by which nutrition curricula are designed and learning objectives are selected, and how theory and pedagogy are applied should be further investigated so that effective approaches to developing garden-enhanced nutrition interventions can be determined and replicated. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Alternative approach for Article 5. Energie Efficiency Directive; Alternatieve aanpak artikel 5. Energy Efficiency Directive

Energy Technology Data Exchange (ETDEWEB)

Menkveld, M.; Jablonska, B. [ECN Beleidsstudies, Petten (Netherlands)

2013-05-15

Article 5 of the Energy Efficiency Directive (EED) is an annual obligation to renovate 3% of the building stock of central government. After renovation the buildings will meet the minimum energy performance requirements laid down in Article 4 of the EPBD. The Directive gives room to an alternative approach to achieve the same savings. The Ministry of Interior Affairs has asked ECN to assist with this alternative approach. ECN calculated what saving are achieved with the 3% renovation obligation under the directive. Then ECN looked for the possibilities for an alternative approach to achieve the same savings [Dutch] In artikel 5 van de Energie Efficiency Directive (EED) staat een verplichting om jaarlijks 3% van de gebouwvoorraad van de centrale overheid te renoveren. Die 3% van de gebouwvoorraad moet na renovatie voldoen aan de minimum eisen inzake energieprestatie die door het betreffende lidstaat zijn vastgelegd op grond van artikel 4 in de EPBD. De verplichting betreft gebouwen die in bezit en in gebruik zijn van de rijksoverheid met een gebruiksoppervlakte groter dan 500 m{sup 2}, vanaf juli 2015 groter dan 250 m{sup 2}. De gebouwen die eigendom zijn van de Rijksgebouwendienst betreft kantoren van rijksdiensten, gerechtsgebouwen, gebouwen van douane en politie en gevangenissen. Van de gebouwen van Defensie hoeven alleen kantoren en legeringsgebouwen aan de verplichting te voldoen.

A proposed alternative approach for protection of inadvertent human intruders from buried Department of Energy low level radioactive wastes

International Nuclear Information System (INIS)

Cochran, J.R.

1995-01-01

The burial of radioactive wastes creates a legacy. To limit the impact of this legacy on future generations, we establish and comply with performance objectives. This paper reviews performance objectives for the long-term isolation of buried radioactive wastes; identifies regulatorly-defined performance objectives for protecting the inadvertent human intruder (IHI) from buried low-level radioactive waste (LLW); (3) discusses a shortcoming of the current approach; and (4) offers an alternative approach for protecting the IHI. This alternative approach is written specifically for the burial of US Department of Energy (DOE) wastes at the Nevada Test Site (NTS), although the approach might be applied at other DOE burial sites

Complementary and alternative medicine for patients with chronic fatigue syndrome: A systematic review

Science.gov (United States)

2011-01-01

Background Throughout the world, patients with chronic diseases/illnesses use complementary and alternative medicines (CAM). The use of CAM is also substantial among patients with diseases/illnesses of unknown aetiology. Chronic fatigue syndrome (CFS), also termed myalgic encephalomyelitis (ME), is no exception. Hence, a systematic review of randomised controlled trials of CAM treatments in patients with CFS/ME was undertaken to summarise the existing evidence from RCTs of CAM treatments in this patient population. Methods Seventeen data sources were searched up to 13th August 2011. All randomised controlled trials (RCTs) of any type of CAM therapy used for treating CFS were included, with the exception of acupuncture and complex herbal medicines; studies were included regardless of blinding. Controlled clinical trials, uncontrolled observational studies, and case studies were excluded. Results A total of 26 RCTs, which included 3,273 participants, met our inclusion criteria. The CAM therapy from the RCTs included the following: mind-body medicine, distant healing, massage, tuina and tai chi, homeopathy, ginseng, and dietary supplementation. Studies of qigong, massage and tuina were demonstrated to have positive effects, whereas distant healing failed to do so. Compared with placebo, homeopathy also had insufficient evidence of symptom improvement in CFS. Seventeen studies tested supplements for CFS. Most of the supplements failed to show beneficial effects for CFS, with the exception of NADH and magnesium. Conclusions The results of our systematic review provide limited evidence for the effectiveness of CAM therapy in relieving symptoms of CFS. However, we are not able to draw firm conclusions concerning CAM therapy for CFS due to the limited number of RCTs for each therapy, the small sample size of each study and the high risk of bias in these trials. Further rigorous RCTs that focus on promising CAM therapies are warranted. PMID:21982120

Diagnosis of flexible flatfoot in children: a systematic clinical approach.

Science.gov (United States)

Benedetti, Maria Grazia; Ceccarelli, Francesco; Berti, Lisa; Luciani, Deianira; Catani, Fabio; Boschi, Marco; Giannini, Sandro

2011-01-01

The goal of this study was to provide measures of symptoms and signs in a consecutive case series of children with flexible flatfoot based on a systematic clinical approach. Fifty-three children (age range, 10-14 years) previously diagnosed with flexible flatfoot were evaluated by a structured interview and clinical assessment. Most patients had foot symptoms (65.3% of feet) and functional limitation (68.3%). Symptoms included a sensation of discomfort (11.3%), such as early tiredness or difficulties during prolonged standing or walking, and pain (54%), mostly located in the plantar aspect of the foot (28.7%) and the medial hindfoot (18.8%). Body mass index was positively correlated to the presence of symptoms and their severity. Even if an enlarged footprint was present in 93.1% of feet, objective assessment evidenced the presence of heel valgus only in 83% of feet. Forefoot adduction was present in 22% of feet. Jack's test provided varus correction in only 54% of feet. Internal knee rotation was the most common associated disalignment, present in 43.6% of limbs. Symptoms were significantly correlated to knee alignment, and functional limitation was correlated to heel valgus. Standing balance on 1 leg was significantly correlated to footprint grading severity. A systematic clinical approach to assess children with flexible flatfoot should always be recommended for the correct diagnosis and the associated treatment management based on symptoms, functional limitation, and foot dysfunction. Functional assessment by specific tests should be included in the examination, as evidence exists that morphology and function are not necessarily related. Copyright 2011, SLACK Incorporated.

Systematic text condensation

DEFF Research Database (Denmark)

Malterud, Kirsti

2012-01-01

To present background, principles, and procedures for a strategy for qualitative analysis called systematic text condensation and discuss this approach compared with related strategies.......To present background, principles, and procedures for a strategy for qualitative analysis called systematic text condensation and discuss this approach compared with related strategies....

Alternative approach to analyzing occupational mortality data

International Nuclear Information System (INIS)

Gilbert, E.S.; Buchanan, J.A.

1984-01-01

It is widely recognized that analyzing occupational mortality by calculating standardized mortality ratios based on death rates from the general population is subject to a number of limitations. An alternative approach described in this report takes advantage of the fact that comparisons of mortality by subgroups and assessments of trends in mortality are often of equal or greater interest than overall assessments and that such comparisons do not require an external control. A computer program MOX (Mortality and Occupational Exposure) is available for performing the needed calculations for several diseases. MOX was written to asses the effect of radiation exposure on Hanford nuclear workers. For this application, analyses have been based on cumulative exposure computed (by MOX) from annual records of radiation exposure obtained from personal dosimeter readings. This program provides tests for differences and trends among subcategories defined by variables such as length of employment, job category, or exposure measurements and also provides control for age, calendar year, and several other potentially confounding variables. 29 references, 2 tables

Systematic approaches to data analysis from the Critical Decision Method

Directory of Open Access Journals (Sweden)

Martin Sedlár

2015-01-01

Full Text Available The aim of the present paper is to introduce how to analyse the qualitative data from the Critical Decision Method. At first, characterizing the method provides the meaningful introduction into the issue. This method used in naturalistic decision making research is one of the cognitive task analysis methods, it is based on the retrospective semistructured interview about critical incident from the work and it may be applied in various domains such as emergency services, military, transport, sport or industry. Researchers can make two types of methodological adaptation. Within-method adaptations modify the way of conducting the interviews and cross-method adaptations combine this method with other related methods. There are many decsriptions of conducting the interview, but the descriptions how the data should be analysed are rare. Some researchers use conventional approaches like content analysis, grounded theory or individual procedures with reference to the objectives of research project. Wong (2004 describes two approaches to data analysis proposed for this method of data collection, which are described and reviewed in the details. They enable systematic work with a large amount of data. The structured approach organizes the data according to an a priori analysis framework and it is suitable for clearly defined object of research. Each incident is studied separately. At first, the decision chart showing the main decision points and then the incident summary are made. These decision points are used to identify the relevant statements from the transcript, which are analysed in terms of the Recognition-Primed Decision Model. Finally, the results from all the analysed incidents are integrated. The limitation of the structured approach is it may not reveal some interesting concepts. The emergent themes approach helps to identify these concepts while maintaining a systematic framework for analysis and it is used for exploratory research design. It

Waste management R ampersand D Quality Assurance: An alternative approach

International Nuclear Information System (INIS)

Brosseau, D.A.; Harlan, C.P.; Cochrell, R.C.

1991-01-01

This paper summarizes the development and initial implementation of a Quality Assurance (QA) Program for technical activities associated with assessing compliance of an existing DOE nuclear waste site with applicable environmental regulations. The requirements for establishing the QA program are defined, along with the approach and emphasis used to develop the program. The structure of the program and the various levels of QA plans and procedures are briefly discussed. Initial implementation efforts are summarized. The QA program was developed by and for the project participants and was structured according to the major technical requirements of the project. The QA plans and procedures are written for the convenience and use of the technical staff and not merely to satisfy auditor expectations. Every effort was made to avoid an 18-point approach typical of many QA programs patterned after the dictates of the industry recognized ''national consensus standards.'' Flexibility is emphasized due to the nature of the research and development activities associated with the technical program. Recommendations are provided for using this alternative approach to QA program development for similar technical efforts elsewhere. 10 refs., 1 fig., 5 tabs

Diet quality as assessed by the Healthy Eating Index, the Alternate Healthy Eating Index, the Dietary Approaches to Stop Hypertension score, and health outcomes: a systematic review and meta-analysis of cohort studies.

Science.gov (United States)

Schwingshackl, Lukas; Hoffmann, Georg

2015-05-01

Dietary patterns consider synergistic effects compared with isolated foods or nutrients on health outcomes. The aim of this systematic review and meta-analysis was to examine the associations of diet quality as assessed by the Healthy Eating Index (HEI), the Alternate Healthy Eating Index (AHEI), and the Dietary Approaches to Stop Hypertension (DASH) score and the risk of all-cause mortality, cardiovascular mortality or incidence, cancer mortality or incidence, type 2 diabetes mellitus, and neurodegenerative diseases. A literature search was performed using the electronic databases MEDLINE, SCOPUS, and EMBASE with an end date of May 10, 2014. Study-specific risk ratios were pooled using a random effect model by the Cochrane software package Review Manager 5.2. Fifteen cohort studies (34 reports), including 1,020,642 subjects, met the criteria and were included in the meta-analysis. Diets of the highest quality, as assessed by the HEI, AHEI, and DASH score, resulted in a significant risk reduction (RR) for all-cause mortality (RR 0.78, 95% CI 0.76 to 0.80; PDiets that score highly on the HEI, AHEI, and DASH are associated with a significant reduction in the risk of all-cause mortality, cardiovascular disease, cancer, and type 2 diabetes mellitus by 22%, 22%, 15%, and 22%, respectively, and therefore is of high public health relevance. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Acupuncture and related therapies used as add-on or alternative to prokinetics for functional dyspepsia: overview of systematic reviews and network meta-analysis

OpenAIRE

Ho, Robin S. T.; Chung, Vincent C. H.; Wong, Charlene H. L.; Wu, Justin C. Y.; Wong, Samuel Y. S.; Wu, Irene X. Y.

2017-01-01

Prokinetics for functional dyspepsia (FD) have relatively higher number needed to treat values. Acupuncture and related therapies could be used as add-on or alternative. An overview of systematic reviews (SRs) and network meta-analyses (NMA) were performed to evaluate the comparative effectiveness of different acupuncture and related therapies. We conducted a comprehensive literature search for SRs of randomized controlled trials (RCTs) in eight international and Chinese databases. Data from ...

A systematic review of online learning programs for nurse preceptors.

Science.gov (United States)

Wu, Xi Vivien; Chan, Yah Shih; Tan, Kimberlyn Hui Shing; Wang, Wenru

2018-01-01

Nurse preceptors guide students to integrate theory into practice, teach clinical skills, assess clinical competency, and enhance problem solving skills. Managing the dual roles of a registered nurse and preceptor poses tremendous challenges to many preceptors. Online learning is recognized as an effective learning approach for enhancing nursing knowledge and skills. The systematic review aims to review and synthesise the online learning programs for preceptors. A systematic review was designed based on the Cochrane Handbook for Systematic Reviews of Programs. Articles published between January 2000 and June 2016 were sought from six electronic databases: CINAHL, Medline OVID, PubMed, Science Direct, Scopus, and Web of Science. All papers were reviewed and quality assessment was performed. Nine studies were finally selected. Data were extracted, organized and analysed using a narrative synthesis. The review identified five overarching themes: development of the online learning programs for nurse preceptors, major contents of the programs, uniqueness of each program, modes of delivery, and outcomes of the programs. The systematic review provides insightful information on educational programs for preceptors. At this information age, online learning offers accessibility, convenience, flexibility, which could of great advantage for the working adults. In addition, the online platform provides an alternative for preceptors who face challenges of workload, time, and support system. Therefore, it is paramount that continuing education courses need to be integrated with technology, increase the flexibility and responsiveness of the nursing workforce, and offer alternative means to take up courses. Copyright © 2017 Elsevier Ltd. All rights reserved.

Equivalence among three alternative approaches to estimating live tree carbon stocks in the eastern United States

Science.gov (United States)

Coeli M. Hoover; James E. Smith

2017-01-01

Assessments of forest carbon are available via multiple alternate tools or applications and are in use to address various regulatory and reporting requirements. The various approaches to making such estimates may or may not be entirely comparable. Knowing how the estimates produced by some commonly used approaches vary across forest types and regions allows users of...

A systematic approach to analyze the social determinants of cardiovascular disease

Science.gov (United States)

Martínez-García, Mireya; Salinas-Ortega, Magaly; Estrada-Arriaga, Iván; Hernández-Lemus, Enrique; García-Herrera, Rodrigo

2018-01-01

Cardiovascular diseases are the leading cause of human mortality worldwide. Among the many factors associated with the etiology, incidence, and evolution of such diseases; social and environmental issues constitute an important and often overlooked component. Understanding to a greater extent the scope to which such social determinants of cardiovascular diseases (SDCVD) occur as well as the connections among them would be useful for public health policy making. Here, we will explore the historical trends and associations among the main SDCVD in the published literature. Our aim will be finding meaningful relations among those that will help us to have an integrated view on this complex phenomenon by providing historical context and a relational framework. To uncover such relations, we used a data mining approach to the current literature, followed by network analysis of the interrelationships discovered. To this end, we systematically mined the PubMed/MEDLINE database for references of published studies on the subject, as outlined by the World Health Organization’s framework on social determinants of health. The analyzed structured corpus consisted in circa 1190 articles categorized by means of the Medical Subheadings (MeSH) content-descriptor. The use of data analytics techniques allowed us to find a number of non-trivial connections among SDCVDs. Such relations may be relevant to get a deeper understanding of the social and environmental issues associated with cardiovascular disease and are often overlooked by traditional literature survey approaches, such as systematic reviews and meta-analyses. PMID:29370200

A systematic approach to analyze the social determinants of cardiovascular disease.

Science.gov (United States)

Martínez-García, Mireya; Salinas-Ortega, Magaly; Estrada-Arriaga, Iván; Hernández-Lemus, Enrique; García-Herrera, Rodrigo; Vallejo, Maite

2018-01-01

Cardiovascular diseases are the leading cause of human mortality worldwide. Among the many factors associated with the etiology, incidence, and evolution of such diseases; social and environmental issues constitute an important and often overlooked component. Understanding to a greater extent the scope to which such social determinants of cardiovascular diseases (SDCVD) occur as well as the connections among them would be useful for public health policy making. Here, we will explore the historical trends and associations among the main SDCVD in the published literature. Our aim will be finding meaningful relations among those that will help us to have an integrated view on this complex phenomenon by providing historical context and a relational framework. To uncover such relations, we used a data mining approach to the current literature, followed by network analysis of the interrelationships discovered. To this end, we systematically mined the PubMed/MEDLINE database for references of published studies on the subject, as outlined by the World Health Organization's framework on social determinants of health. The analyzed structured corpus consisted in circa 1190 articles categorized by means of the Medical Subheadings (MeSH) content-descriptor. The use of data analytics techniques allowed us to find a number of non-trivial connections among SDCVDs. Such relations may be relevant to get a deeper understanding of the social and environmental issues associated with cardiovascular disease and are often overlooked by traditional literature survey approaches, such as systematic reviews and meta-analyses.

Diverse alternative back-splicing and alternative splicing landscape of circular RNAs

Science.gov (United States)

Zhang, Xiao-Ou; Dong, Rui; Zhang, Yang; Zhang, Jia-Lin; Luo, Zheng; Zhang, Jun; Chen, Ling-Ling; Yang, Li

2016-01-01

Circular RNAs (circRNAs) derived from back-spliced exons have been widely identified as being co-expressed with their linear counterparts. A single gene locus can produce multiple circRNAs through alternative back-splice site selection and/or alternative splice site selection; however, a detailed map of alternative back-splicing/splicing in circRNAs is lacking. Here, with the upgraded CIRCexplorer2 pipeline, we systematically annotated different types of alternative back-splicing and alternative splicing events in circRNAs from various cell lines. Compared with their linear cognate RNAs, circRNAs exhibited distinct patterns of alternative back-splicing and alternative splicing. Alternative back-splice site selection was correlated with the competition of putative RNA pairs across introns that bracket alternative back-splice sites. In addition, all four basic types of alternative splicing that have been identified in the (linear) mRNA process were found within circRNAs, and many exons were predominantly spliced in circRNAs. Unexpectedly, thousands of previously unannotated exons were detected in circRNAs from the examined cell lines. Although these novel exons had similar splice site strength, they were much less conserved than known exons in sequences. Finally, both alternative back-splicing and circRNA-predominant alternative splicing were highly diverse among the examined cell lines. All of the identified alternative back-splicing and alternative splicing in circRNAs are available in the CIRCpedia database (http://www.picb.ac.cn/rnomics/circpedia). Collectively, the annotation of alternative back-splicing and alternative splicing in circRNAs provides a valuable resource for depicting the complexity of circRNA biogenesis and for studying the potential functions of circRNAs in different cells. PMID:27365365

A panoramic view of the skull base: systematic review of open and endoscopic endonasal approaches to four tumors.

Science.gov (United States)

Graffeo, Christopher S; Dietrich, August R; Grobelny, Bartosz; Zhang, Meng; Goldberg, Judith D; Golfinos, John G; Lebowitz, Richard; Kleinberg, David; Placantonakis, Dimitris G

2014-08-01

Endoscopic endonasal surgery has been established as the safest approach to pituitary tumors, yet its role in other common skull base lesions has not been established. To answer this question, we carried out a systematic review of reported series of open and endoscopic endonasal approaches to four major skull base tumors: olfactory groove meningiomas (OGM), tuberculum sellae meningiomas (TSM), craniopharyngiomas (CRA), and clival chordomas (CHO). Data from 162 studies containing 5,701 patients were combined and compared for differences in perioperative mortality, gross total resection (GTR), cerebrospinal fluid (CSF) leak, neurological morbidity, post-operative visual function, post-operative anosmia, post-operative diabetes insipidus (DI), and post-operative obesity/hyperphagia. Weighted average rates for each outcome were calculated using relative study size. Our findings indicate similar rates of GTR and perioperative mortality between open and endoscopic approaches for all tumor types. CSF leak was increased after endoscopic surgery. Visual function symptoms were more likely to improve after endoscopic surgery for TSM, CRA, and CHO. Post-operative DI and obesity/hyperphagia were significantly increased after open resection in CRA. Recurrence rates per 1,000 patient-years of follow-up were higher in endoscopy for OGM, TSM, and CHO. Trends for open and endoscopic surgery suggested modest improvement in all outcomes over time. Our observations suggest that endonasal endoscopy is a safe alternative to craniotomy and may be preferred for certain tumor types. However, endoscopic surgery is associated with higher rates of CSF leak, and possibly increased recurrence rates. Prospective study with long-term follow-up is required to verify these preliminary observations.

A Systematic Approach to Process Evaluation in the Central Oklahoma Turning Point (COTP) Partnership

Science.gov (United States)

Tolma, Eleni L.; Cheney, Marshall K.; Chrislip, David D.; Blankenship, Derek; Troup, Pam; Hann, Neil

2011-01-01

Formation is an important stage of partnership development. Purpose: To describe the systematic approach to process evaluation of a Turning Point initiative in central Oklahoma during the formation stage. The nine-month collaborative effort aimed to develop an action plan to promote health. Methods: A sound planning framework was used in the…

A Systematic Approach to Cultural Explanations of War: Tracing Causal Processes in Two West African Insurgencies

NARCIS (Netherlands)

Richards, P.

2011-01-01

Many accounts of cultural factors in armed conflicts are dependent on circumstantial details. Alternative quantitative approaches suffer from confusion of correlation and cause. This paper describes and exemplifies a third approach to the analysis of cultural factors in war—causal process tracing.

The Declining Suitability of the Formula Approach to Funding Fublic Higher Education: Rationale and Alternatives.

Science.gov (United States)

Temple, Charles M.; Riggs, Robert O.

1978-01-01

After discussing and analyzing three available alternative budgeting approaches, including incremental, program budgeting, and zero-based budgeting, this article suggests the criteria necessary for a newly adapted system and contends that a program budgeting system would serve most effectively. (DS)

Utility of a Systematic Approach to Teaching Photographic Nasal Analysis to Otolaryngology Residents.

Science.gov (United States)

Robitschek, Jon; Dresner, Harley; Hilger, Peter

2017-12-01

Photographic nasal analysis constitutes a critical step along the path toward accurate diagnosis and precise surgical planning in rhinoplasty. The learned process by which one assesses photographs, analyzes relevant anatomical landmarks, and generates a global view of the nasal aesthetic is less widely described. To discern the common pitfalls in performing photographic nasal analysis and to quantify the utility of a systematic approach model in teaching photographic nasal analysis to otolaryngology residents. This prospective observational study included 20 participants from a university-based otolaryngology residency program. The control and intervention groups underwent baseline graded assessment of 3 patients. The intervention group received instruction on a systematic approach model for nasal analysis, and both groups underwent postintervention testing at 10 weeks. Data were collected from October 1, 2015, through June 1, 2016. A 10-minute, 11-slide presentation provided instruction on a systematic approach to nasal analysis to the intervention group. Graded photographic nasal analysis using a binary 18-point system. The 20 otolaryngology residents (15 men and 5 women; age range, 24-34 years) were adept at mentioning dorsal deviation and dorsal profile with focused descriptions of tip angle and contour. Areas commonly omitted by residents included verification of the Frankfort plane, position of the lower lateral crura, radix position, and ratio of the ala to tip lobule. The intervention group demonstrated immediate improvement after instruction on the teaching model, with the mean (SD) postintervention test score doubling compared with their baseline performance (7.5 [2.7] vs 10.3 [2.5]; P Otolaryngology residents demonstrated proficiency at incorporating nasal deviation, tip angle, and dorsal profile contour into their nasal analysis. They often omitted verification of the Frankfort plane, position of lower lateral crura, radix depth, and ala-to-tip lobule

Application of Systematic Approach to the Study of Financial and Credit Infrastructure of Agriculture

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Aleksandr Vladimirovich Dorzhdeev

2015-12-01

Full Text Available The increasing value of development of financial and credit infrastructure of agriculture in reproduction activity of agricultural producers is caused by the need of continuous receipt of funds for financing the requirements of agriculture and limited opportunities of selffinancing as a result of rather high capital intensity at rather low level of profitability. The systematic approach to research of financial and credit infrastructure of agriculture assumes its consideration as a set of the interconnected and interdependent subsystems and their elements focused on performance of certain functions. The use of systematic approach deepens complete theoretical ideas about the financial and credit infrastructure of agriculture. In the present article the essence of financial and credit infrastructure of agriculture in the points of view of functional and institutional aspects is opened, its subsystems are characterized, their functions and elements are defined by the authors. The study of the systemic features of market infrastructure allowed the authors to reveal the signs peculiar to financial and credit infrastructure of agricultural sector.

Alternative approach to estimate the hydrolysis rate constant of particulate material from batch data

International Nuclear Information System (INIS)

Koch, Konrad; Drewes, Jörg E.

2014-01-01

Highlights: • An alternative to the commonly used first-order approach is presented. • A relationship between k h and the 1% criterion of the VDI 4630 is deduced. • Equation is proposed to directly calculate k h without the need for data fitting. • Hydrolysis constant k h can then easily be read-off from a table. - Abstract: As anaerobic batch tests are easy to conduct, they are commonly used to assess the effects of different operational factors on the anaerobic digestion process. Hydrolysis of particulate material is often assumed to be the rate limiting step in anaerobic digestion. Its velocity is often estimated by data fitting from batch tests. In this study, a Monod-type alternative to the commonly used first-order approach is presented. The approach was adapted from balancing a continuously stirred-tank reactor and better accommodates the fact that even after a long incubation time, some of the methane potential of the substrate remains untapped in the digestate. In addition, an equation is proposed to directly calculate the hydrolysis constant from the time when the daily gas production is less than 1% of the total gas production. The hydrolysis constant can then easily be read-off from a table when the batch test duration is known

A systematic review of Bayesian articles in psychology : The last 25 years

OpenAIRE

van de Schoot, Rens; Winter, Sonja; Ryan, Oisín; Zondervan - Zwijnenburg, Mariëlle; Depaoli, Sarah

2017-01-01

Although the statistical tools most often used by researchers in the field of psychology over the last 25 years are based on frequentist statistics, it is often claimed that the alternative Bayesian approach to statistics is gaining in popularity. In the current article, we investigated this claim by performing the very first systematic review of Bayesian psychological articles published between 1990 and 2015 (n = 1,579). We aim to provide a thorough presentation of the role Bayesian statisti...

Successful management of Barth syndrome: a systematic review highlighting the importance of a flexible and multidisciplinary approach

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Reynolds S

2015-07-01

Full Text Available Stacey Reynolds Department of Occupational Therapy, Virginia Commonwealth University, Richmond, VA, USA Abstract: This review describes and summarizes the available evidence related to the treatment and management of Barth syndrome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA standards were used to identify articles published between December 2004 and January 2015. The Cochrane Population, Intervention, Control, Outcome, Study Design (PICOS approach was used to guide the article selection and evaluation process. Of the 128 articles screened, 28 articles matched the systematic review inclusion criteria. The results of this review indicate the need for a flexible and multidisciplinary approach to manage the symptoms most commonly associated with Barth syndrome. It is recommended that a comprehensive care team should include individuals with Barth syndrome, their family members and caregivers, as well as medical, rehabilitative, nutritional, psychological, and educational professionals. The evidence for specific treatments, therapies, and techniques for individuals with Barth syndrome is currently lacking in both quality and quantity. Keywords: Barth syndrome, rare disorders, rehabilitation, cardiac, systematic review

Systematic approach for the design of pumpable cement-based grouts for immobilization of hazardous wastes

International Nuclear Information System (INIS)

Sams, T.L.; Gilliam, T.M.

1987-01-01

Cement-based grouts have been proven to be an economical and environmentally acceptable means of waste disposal. Costs can be reduced if the grout is pumped to the disposal site. This paper presents a systematic approach to guide the development of pumpable grouts. 20 refs., 2 figs

Beyond face-to-face individual counseling: A systematic review on alternative modes of motivational interviewing in substance abuse treatment and prevention.

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Jiang, Shan; Wu, Lingli; Gao, Xiaoli

2017-10-01

This systematic review aimed to synthesize the evidence on the effectiveness of motivational interviewing (MI), delivered in modes other than face-to-face individual counseling, in preventing and treating substance abuse related behaviors. Four databases (PubMed/MEDLINE, PsycINFO, ISI Web of Science and Cochrane Library) were searched for randomised clinical trials (RCTs) that evaluated the effectiveness of alternative modes of MI (other than face-to-face individual counseling) in preventing and treating substance abuse. Eligible studies were rated on methodological quality and their findings were qualitatively synthesized. A total of 25 articles (on 22 RCTs) were eligible for this review. Beyond face-to-face counseling, telephone was the most frequently used medium for delivering MI (11 studies), followed by Internet communication (4 studies) and short message service (SMS) (2 studies). Mail was incorporated as a supplement in one of the studies for telephone MI. In contrast to one-to-one individual counseling, group MI was adopted in 5 studies. The effectiveness of telephone MI in treating substance abuse was supported by all of the published RCTs we located. Internet-based MI was effective in preventing and treating alcoholism, but its outcome appeared to be inconsistent for smoking cessation and poor for abstinence from illicit drugs. SMS-based MI appeared to be useful for controlling tobacco and drinking. Group MI was attempted for quitting alcohol and drugs, with mixed findings on its outcomes. Collectively, the studies reviewed indicate that telephone MI is a promising mode of intervention in treating and preventing substance abuse. The effectiveness of other alternative modes (SMS-based MI, Internet-based MI and group MI) remains inconclusive given the controversial findings and a limited number of studies. By synthesizing the currently available evidence, this systematic review suggested that telephone MI might be considered as an alternative to face

Systematic evaluation of drug-disease relationships to identify leads for novel drug uses.

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Chiang, A P; Butte, A J

2009-11-01

Drug repositioning refers to the discovery of alternative uses for drugs--uses that are different from that for which the drugs were originally intended. One challenge in this effort lies in choosing the indication for which a drug of interest could be prospectively tested. We systematically evaluated a drug treatment-based view of diseases in order to address this challenge. Suggestions for novel drug uses were generated using a "guilt by association" approach. When compared with a control group of drug uses, the suggested novel drug uses generated by this approach were significantly enriched with respect to previous and ongoing clinical trials.

A Systematic Approach for Quantitative Analysis of Multidisciplinary Design Optimization Framework

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Kim, Sangho; Park, Jungkeun; Lee, Jeong-Oog; Lee, Jae-Woo

An efficient Multidisciplinary Design and Optimization (MDO) framework for an aerospace engineering system should use and integrate distributed resources such as various analysis codes, optimization codes, Computer Aided Design (CAD) tools, Data Base Management Systems (DBMS), etc. in a heterogeneous environment, and need to provide user-friendly graphical user interfaces. In this paper, we propose a systematic approach for determining a reference MDO framework and for evaluating MDO frameworks. The proposed approach incorporates two well-known methods, Analytic Hierarchy Process (AHP) and Quality Function Deployment (QFD), in order to provide a quantitative analysis of the qualitative criteria of MDO frameworks. Identification and hierarchy of the framework requirements and the corresponding solutions for the reference MDO frameworks, the general one and the aircraft oriented one were carefully investigated. The reference frameworks were also quantitatively identified using AHP and QFD. An assessment of three in-house frameworks was then performed. The results produced clear and useful guidelines for improvement of the in-house MDO frameworks and showed the feasibility of the proposed approach for evaluating an MDO framework without a human interference.

Domain Approach: An Alternative Approach in Moral Education

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Vengadasalam, Chander; Mamat, Wan Hasmah Wan; Mail, Fauziah; Sudramanian, Munimah

2014-01-01

This paper discusses the use of the domain approach in moral education in an upper secondary school in Malaysia. Moral Education needs a creative and an innovative approach. Therefore, a few forms of approaches are used in the teaching-learning of Moral Education. This research describes the use of domain approach which comprises the moral domain…

Improving early detection of gastric cancer: a novel systematic alphanumeric-coded endoscopic approach.

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Emura, Fabian; Gralnek, Ian; Baron, Todd H

2013-01-01

Despite extensive worldwide use of standard esophagogastroduodenoscopy (EGD) examinations, gastric cancer (GC) is one of the most common forms of cancer and ranks as the most common malignant tumor in East Asia, Eastern Europe and parts of Latin America. Current limitations of using non systematic examination during standard EGD could be at least partially responsible for the low incidence of early GC diagnosis in countries with a high prevalence of the disease. Originally proposed by Emura et al., systematic alphanumeric-coded endoscopy (SACE) is a novel method that facilitates complete examination of the upper GI tract based on sequential systematic overlapping photo-documentation using an endoluminal alphanumeric-coded nomenclature comprised of eight regions and 28 areas covering the entire surface upper GI surface. For precise localization or normal or abnormal areas, SACE incorporates a simple coordinate system based on the identification of certain natural axes, walls, curvatures and anatomical endoluminal landmarks. Efectiveness of SACE was recently demonstrated in a screening study that diagnosed early GC at a frequency of 0.30% (2/650) in healthy, average-risk volunteer subjects. Such a novel approach, if uniformly implemented worldwide, could significantly change the way we practice upper endoscopy in our lifetimes.

Comparative lifecycle assessment of alternatives for waste management in Rio de Janeiro - Investigating the influence of an attributional or consequential approach.

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Bernstad Saraiva, A; Souza, R G; Valle, R A B

2017-10-01

The environmental impacts from three management alternatives for organic fraction of municipal solid waste were compared using lifecycle assessment methodology. The alternatives (sanitary landfill, selective collection of organic waste for anaerobic digestion and anaerobic digestion after post-separation of organic waste) were modelled applying an attributional as well as consequential approach, in parallel with the aim of identifying if and how these approaches can affect results and conclusions. The marginal processes identified in the consequential modelling were in general associated with higher environmental impacts than average processes modelled with an attributional approach. As all investigated waste management alternatives result in net-substitution of energy and in some cases also materials, the consequential modelling resulted in lower absolute environmental impacts in five of the seven environmental impact categories assessed in the study. In three of these, the chosen modelling approach can alter the hierarchy between compared waste management alternatives. This indicates a risk of underestimating potential benefits from efficient energy recovery from waste when applying attributional modelling in contexts in which electricity provision historically has been dominated by technologies presenting rather low environmental impacts, but where projections point at increasing impacts from electricity provision in coming years. Thus, in the present case study, the chosen approach affects both absolute and relative results from the comparison. However, results were largely related to the processes identified as affected by investigated changes, and not merely the chosen modelling approach. The processes actually affected by future choices between different waste management alternatives are intrinsically uncertain. The study demonstrates the benefits of applying different assumptions regarding the processes affected by investigated choices - both for provision

Use of Machine-Learning Approaches to Predict Clinical Deterioration in Critically Ill Patients: A Systematic Review

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Tadashi Kamio

2017-06-01

Full Text Available Introduction: Early identification of patients with unexpected clinical deterioration is a matter of serious concern. Previous studies have shown that early intervention on a patient whose health is deteriorating improves the patient outcome, and machine-learning-based approaches to predict clinical deterioration may contribute to precision improvement. To date, however, no systematic review in this area is available. Methods: We completed a search on PubMed on January 22, 2017 as well as a review of the articles identified by study authors involved in this area of research following the preferred reporting items for systematic reviews and meta-analyses (PRISMA guidelines for systematic reviews. Results: Twelve articles were selected for the current study from 273 articles initially obtained from the PubMed searches. Eleven of the 12 studies were retrospective studies, and no randomized controlled trials were performed. Although the artificial neural network techniques were the most frequently used and provided high precision and accuracy, we failed to identify articles that showed improvement in the patient outcome. Limitations were reported related to generalizability, complexity of models, and technical knowledge. Conclusions: This review shows that machine-learning approaches can improve prediction of clinical deterioration compared with traditional methods. However, these techniques will require further external validation before widespread clinical acceptance can be achieved.

Administration by Objectives: A Systematic Approach to Educational Planning in Virginia. Report of a Study.

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Holmes, George W., III; Seawell, William H.

This report presents (1) details of a program for educational administration by objectives and (2) the results of such a program developed by the Virginia State Department of Education to upgrade the quality of education in the public schools of that State. Administration by objectives is a systematic approach to education planning using…

A systematic assessment of normalization approaches for the Infinium 450K methylation platform.

Science.gov (United States)

Wu, Michael C; Joubert, Bonnie R; Kuan, Pei-fen; Håberg, Siri E; Nystad, Wenche; Peddada, Shyamal D; London, Stephanie J

2014-02-01

The Illumina Infinium HumanMethylation450 BeadChip has emerged as one of the most popular platforms for genome wide profiling of DNA methylation. While the technology is wide-spread, systematic technical biases are believed to be present in the data. For example, this array incorporates two different chemical assays, i.e., Type I and Type II probes, which exhibit different technical characteristics and potentially complicate the computational and statistical analysis. Several normalization methods have been introduced recently to adjust for possible biases. However, there is considerable debate within the field on which normalization procedure should be used and indeed whether normalization is even necessary. Yet despite the importance of the question, there has been little comprehensive comparison of normalization methods. We sought to systematically compare several popular normalization approaches using the Norwegian Mother and Child Cohort Study (MoBa) methylation data set and the technical replicates analyzed with it as a case study. We assessed both the reproducibility between technical replicates following normalization and the effect of normalization on association analysis. Results indicate that the raw data are already highly reproducible, some normalization approaches can slightly improve reproducibility, but other normalization approaches may introduce more variability into the data. Results also suggest that differences in association analysis after applying different normalizations are not large when the signal is strong, but when the signal is more modest, different normalizations can yield very different numbers of findings that meet a weaker statistical significance threshold. Overall, our work provides useful, objective assessment of the effectiveness of key normalization methods.

Using text mining for study identification in systematic reviews: a systematic review of current approaches

OpenAIRE

O?Mara-Eves, Alison; Thomas, James; McNaught, John; Miwa, Makoto; Ananiadou, Sophia

2015-01-01

Background The large and growing number of published studies, and their increasing rate of publication, makes the task of identifying relevant studies in an unbiased way for inclusion in systematic reviews both complex and time consuming. Text mining has been offered as a potential solution: through automating some of the screening process, reviewer time can be saved. The evidence base around the use of text mining for screening has not yet been pulled together systematically; this systematic...

Communicating with parents of children with autism about vaccines and complementary and alternative approaches.

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Gupta, Vidya Bhushan

2010-05-01

Despite incontrovertible evidence that vaccines do not cause autism, some parents continue to refuse them and many parents of children with autism seek hope in unproven and potentially harmful complementary and alternative (CAM) approaches. This commentary explores the reasons for such behaviors and proposes that pediatricians may support parents in their pursuit of hope in unproven treatments as long as these are not potentially harmful to the child or prohibitively expensive. While respecting parental autonomy and hope the pediatricians should share with parents their concerns about lack of scientific evidence about CAM and potential for harm by some approaches.

Benefits of a systematic approach to maintenance for safety and safety related systems

International Nuclear Information System (INIS)

Dam, R.F.; Ayazzudin, S.; Nickerson, J.H.

2003-01-01

For safety and safety-related systems, nuclear plants have to balance the requirements of demonstrating the reliability of each system, while maintaining the system and plant availability. With the goal of demonstrating statistical reliability, these systems have extensive testing programs, which often results in system unavailability and this can impact the plant capacity. The inputs to the process are often safety and regulatory related, resulting in programs that provide a high level of scrutiny. In such cases, the value of the application of a Systematic Assessment of Maintenance (SAM) process, such as Reliability Centered Maintenance (RCM), is questioned. The special case of Standby-Safety systems was discussed in a previous paper, where it was demonstrated how SAM techniques provide useful insight into current system performance, the impact of testing on component and system reliability, and how PSA considerations can be integrated into a comprehensive Maintenance, Surveillance, and Inspection (MSI) strategy. Although the system reliability requirements are an important part of the strategy evaluation, SAM techniques provide a systematic assessment within a broader context. Testing is only one part of an overall strategy focused on ensuring that component function is maintained through a combination of monitoring technologies (including testing), predictive techniques, and intrusive maintenance strategies. Each strategy is targeted to known component degradation mechanisms. This thinking can be extended to safety and safety related systems in general. Over the past 6 years, AECL has been working with CANDU utilities in the development and implementation of a comprehensive and integrated Plant Life Management (PLiM) program. As part of developing a comprehensive plant asset management approach, SAM techniques are used to develop a technical basis that not only works towards ensuring reliable operation of plant systems, but also facilitates the optimization and

Modern approach to the problem of fossil gas fuels replacement by alternative fuels

Energy Technology Data Exchange (ETDEWEB)

Soroka, Boris [Gas Institute, National Academy of Sciences, Kiev (Ukraine)

2013-07-01

New scientific and engineering fundamentals of fuels substitution have been developed instead of obsolete methodology “Interchangeability of Fuel Gases” developed in USA and existing from the middle of XX{sup th} century. To perform the complex prediction of total or partial substitution of given flow rate of natural gas NG for alternative gases AG the following parameters are to be predicted: plant utilization efficiencies – regarding fuel and energy utilization, the last in form of heat Ș{sub H} and exergy Ș{sub eff} efficiencies, saving or overexpenditure of the NG flow rate in the gas mixture with AG, specific fuel consumption b f and specific issue of harmful substances C{sub t} – pollutants in the combustion products (C{sub NO{sub x}} ) and greenhouse gases (C {sub CO{sub 2}} ). Certification of alternative gas fuels and fuel mixtures as a commodity products is carried out in frame of our approach with necessary set of characteristics, similar to those accepted in the world practice. Key words: alternative fuel, fuel replacement (substitution), natural gas, process gases, theoretical combustion temperature, thermodynamic equilibrium computations, total enthalpy.

Alternate approaches to nuclear safety

International Nuclear Information System (INIS)

Crane, A.T.

1985-01-01

For the US nuclear power industry to expand, a greatly increased portion of the public must come to share the industry's confidence in reactor safety. Major obstacles to establishing this confidence are frequent incidents with potential safety implications and a lack of incontrovertible proof that the risk of a major accident is very low. The most important step toward overcoming these obstacles would be for each utility to operate, maintain, and evaluate its reactors according to far higher standards. With improvements in reliability and safety margins, existing plants would be a stimulus for building new ones rather than an impediment. If changes to the operation of existing plants and improvements to the design of future ones were inadequate, the only hope for a revival of the nuclear industry would be an alternative reactor so obviously safe that risk would no longer be an issue. Three possible concepts are the modular high-temperature gas reactor, the process inherent ultimate safety reactor, and the liquid-metal fast reactor. All three have inherent safety features that should make a meltdown essentially impossible. They cannot know just how great the advantage of these alternate reactors would be, but the benefits of developing one or more of the concepts appear great

Augmentative Approaches in Family-Based Treatment for Adolescents with Restrictive Eating Disorders: A Systematic Review.

Science.gov (United States)

Richards, Imogen Lim; Subar, Anni; Touyz, Stephen; Rhodes, Paul

2018-03-01

To systematically review the literature reporting outcomes of augmentative family-based treatment (FBT) interventions for adolescents with restrictive eating disorders (EDs). Articles were identified through a systematic search of five electronic databases (PsycINFO, MEDLINE, EMBASE, CINAHL, Cochrane Database). Thirty articles were included, reporting on FBT augmentations featuring adjunctive treatment components, modified treatment structure and/or content with adherence to FBT principles, and adaptations allowing FBT delivery in different settings. All reported significant improvements in weight and/or ED symptoms at end-of-treatment, although few compared augmentative and standard FBT interventions and good quality follow-up data was generally lacking. There is early evidence for the effectiveness of augmentative FBT-based approaches in facilitating weight and/or ED symptom improvements for adolescents with restrictive EDs. There remains a lack of robust evidence demonstrating superior effects of such approaches over standard FBT, and further controlled studies are required to expand on the current evidence. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Effectiveness of Music Therapy in Alzheimer Patients: Systematic Review

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Neslihan Lok

Full Text Available The incidence of Alzheimers disease increases with advancing age. This increase cause significant economic and emotional burden on family and national health care system which makes Alzheimers disease a national issue to be considered. Music therapy could be an alternative treatment approach in Alzheimer's disease. Especially in the second stage of Alzheimers disease, growth and expansion of amyloid plaques results in anger and aggression among patients. Calming effects of music might be beneficial in management of patients during this period. This study is a systematic review of researches conducted to determine the effects of music therapy in Alzheimer's diseases. In sum results have supported possible positive effects of music therapy on Alzheimer patients. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(3.000: 266-274

Prioritizing health: a systematic approach to scoping determinants in health impact assessment

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Lindsay McCallum

2016-08-01

Full Text Available The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of Health Impact Assessment (HIA, the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted including both primary and grey literature. A total of 10 HIA Scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors such as impact, public concern and data availability to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programmed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

Complementary and alternative interventions in atopic dermatitis.

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Lee, Joohee; Bielory, Leonard

2010-08-01

The burden of atopic diseases, including atopic dermatitis (AD), is significant and far-reaching. In addition to cost of care and therapies, it affects the quality of life for those affected as well as their caretakers. Complementary and alternative therapies are commonly used because of concerns about potential adverse effects of conventional therapies and frustration with the lack of response to prescribed medications, be it due to the severity of the AD or the lack of appropriate regular use. Despite the promising results reported with various herbal medicines and biologic products, the clinical efficacy of such alternative therapies remains to be determined. Physicians need to be educated about alternative therapies and discuss benefits and potential adverse effects or limitations with patients. A systematic approach and awareness of reputable and easily accessible resources are helpful in dealing with complementary and alternative medicine (CAM). The use of CAM interventions is common among individuals with AD. Epidemiologic data have been a motivating drive for better elucidation of the efficacy of CAM interventions for allergic disease. Herbal medicines and biologics for AD treatment and, more recently, prevention comprise a major area of clinical investigation. Potential mechanisms of therapeutic effect elucidated by animal models and human clinical studies implicate modulation of TH2-type allergic inflammation and induction of immune tolerance. Population-based research regarding the use of CAM for allergic diseases underscores the increasing challenge for care providers with respect to identifying CAM use and ensuring safe use of allopathic and complementary medicines in disease management. Copyright 2010. Published by Elsevier Inc.

What do Cochrane systematic reviews say about non-surgical interventions for urinary incontinence in women?

Science.gov (United States)

Costa, Anderson Adriano Leal Freitas da; Vasconcellos, Igor Martins; Pacheco, Rafael Leite; Bella, Zsuzsanna Ilona Katalin de Jármy Di; Riera, Rachel

2018-01-01

Urinary incontinence is a highly prevalent condition that impacts self-esteem and overall quality of life. Many non-surgical treatment options are available, ranging from pharmacological approaches to pelvic exercises. We aimed to summarize the available evidence regarding these non-surgical interventions. Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP). A sensitive search was conducted to identify all Cochrane systematic reviews that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. We included 20 Cochrane systematic reviews: 4 assessing methods of vesical training, 3 evaluating pharmacological interventions, 4 studying pelvic floor muscle training approaches and 9 aimed at other alternatives (such as urethral injections, weighted vaginal cone use, acupuncture, biostimulation and radiofrequency therapy). The reviews found that the evidence regarding the benefits of these diverse interventions ranged in quality from low to high. This review included 20 Cochrane systematic reviews that provided evidence (of diverse quality) for non-pharmacological interventions for patients with urinary incontinence. Moderate to high quality of evidence was found favoring the use of pelvic floor muscle training among women with urinary incontinence. To establish solid conclusions for all the other comparisons, further studies of good methodological quality are needed.

A Systematic Review of the Measurement of Sustainable Diets123

Science.gov (United States)

Hoey, Lesli; Blesh, Jennifer; Miller, Laura; Green, Ashley; Shapiro, Lilly Fink

2016-01-01

Sustainability has become an integral consideration of the dietary guidelines of many countries in recent decades. However, a lack of clear metrics and a shared approach to measuring the multiple components of sustainable diets has hindered progress toward generating the evidence needed to ensure the credibility of new guidelines. We performed a systematic literature review of empirical research studies on sustainable diets to identify the components of sustainability that were measured and the methods applied to do so. Two independent reviewers systematically searched 30 databases and other sources with the use of a uniform set of search terms and a priori exclusion criteria. In total, 113 empirical studies were included in the final review. Nearly all of the studies were focused on high-income countries. Although there was substantial heterogeneity in the components of sustainability measured, the estimated greenhouse gas emissions (GHGEs) of various dietary patterns were by far most commonly measured (n = 71 studies). Estimating the GHGEs of foods through various stages of production, use, and recycling with the use of the Life Cycle Assessment approach was the most common method applied to measure the environmental impacts of diets (n = 49 studies). Many components of sustainable diets identified in existing conceptual frameworks are disproportionately underrepresented in the empirical literature, as are studies that examine consumer demand for sustainable dietary alternatives. The emphasis in the literature on high-income countries also overlooks the production and dietary alternatives most relevant to low- and middle-income countries. We propose 3 methodological and measurement approaches that would both improve the global relevance of our understanding of sustainable diets and attend more completely to the existing multidimensional, multiscale conceptual framing of sustainable diets. PMID:27422501

Alternative Educational Approach to Introducing Cell Biology

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Rosilane T. Silva

2005-07-01

Full Text Available First year medical students usually have a great  difficulty to visualize a three  dimensional  cell. They also present a series of misconceptions  related to cell biology that seems to begin in the high school. An alternative educational approach  is being tested  with high school students in order to minimize these misconceptions,  and also increase the pupils interest in the subject.  The approach  combines theoretical classes with experimental activities, the  use of models, games, discussions,  and oral presentations by the students at the end of the educational module.  In short,  the experimental activities  are low-cost, easy-to-follow experiments that basically show a few properties  of the living cells, such as membrane transport, enzyme action  as well as the  importance of the  membrane  integrity for life.  A card  game relates  the  functions  of the organnels  by matching  pairs  of cards.  This  game has one card without a matching  pair  that explains  apoptosis;  the  player  that ends up with  this  card  loses the game.   The pupils learn while they play the game.  A 3D model of the membrane  shows the major components  and allows the observation of membrane  assimetry.   After comparing  some panels of photomicrographs of cells and organnels, the students are presented  to a 3D model of a cell as the teacher  tries to relate the panels  with  a three  dimensional  visualization.  They  also have the  opportunity to present their  own models.  The opinion of high school teachers  about  the different activities  will be shown.  The aim of this educational module is to promote  learning while different abilities, according to Gardners  Multiple Intelligences  Theory,  such as the visual-spatial, bodily-kinesthetic, interpersonal, and naturalistic are being developed.  We believe that the diversity  of approaches  is one of the most important

[The positive deviance approach to change nutrition behavior: a systematic review].

Science.gov (United States)

Machado, Juliana Costa; Cotta, Rosângela Minardi Mitre; Silva, Luciana Saraiva da

2014-08-01

To conduct a systematic review of the literature describing the use of the positive deviance approach to change nutrition behavior in order to identify the potentials of this method for health and nutrition education. Cochrane Library, LILACS, MEDLINE, SciELO, PubMed, and Scopus were searched. The following search terms were used: positive deviance, desvio positivo, positive deviance inquiry and positive deviants. Inclusion criteria were: reporting primary data, clearly defined methods, and availability of full text. The main results of the studies selected for inclusion were described and examined based on psychosocial (socioeconomic and health status, hygiene and nutrition habits), anthropometric (weight, height), and biochemical and clinical (presence of morbidity and biochemical tests) criteria to determine the potential and limitations of the positive deviance approach to change nutrition behavior. Of the 47 studies identified, nine met the inclusion criteria. The positive deviance method was used for prevention and rehabilitation of child and maternal malnutrition in areas of socioeconomic vulnerability and for the treatment of overweight and obesity in adults. An improvement in maternal and child nutrition and the maintenance of beneficial behaviors over time were underscored as positive impacts of the method. The positive deviance approach may help change nutrition behaviors with the aim of reversing child malnutrition and overweight and obesity in adults. This approach seems effective to promote health education in areas of socioeconomic vulnerability.

Alternative approach of developing all-optical Fredkin and Toffoli gates

Science.gov (United States)

Mandal, Dhoumendra; Mandal, Sumana; Garai, Sisir Kumar

2015-09-01

Reversible logic gates show potential roles in communication technology, and it has a wide area of applicability such as in sequential and combinational circuit of optical computing, optical signal processing, multi-valued logic operations, etc. because of its advantageous aspects of data-recovering capabilities, low power consumption, least power dissipation, faster speed of processing, less hardware complexity, etc. In a reversible logic gate not only the outputs can be determined from the inputs, but also the inputs can be uniquely recovered from the outputs. In this article an alternative approach has been made to develop three-input-output Fredkin and Toffoli gates using the frequency conversion property of semiconductor optical amplifier (SOA) and frequency-based beam routing by optical multiplexers and demultiplexers. Simulation results show the feasibility of our proposed scheme.

A systematic approach for the assessment of bacterial growth-controlling factors linked to biological stability of drinking water in distribution systems

KAUST Repository

Prest, E. I.; Hammes, F.; Kotzsch, S.; van Loosdrecht, M. C. M.; Vrouwenvelder, Johannes S.

2016-01-01

A systematic approach is presented for the assessment of (i) bacterial growth-controlling factors in drinking water and (ii) the impact of distribution conditions on the extent of bacterial growth in full-scale distribution systems. The approach

Alternative Approaches to the Analysis of Multidimensional Contingency Tables

Directory of Open Access Journals (Sweden)

Iva Pecáková

2011-12-01

Full Text Available The practical analyses of interactions between categorical variables in various areas (such as public opinion research or marketing research are often only applications of chi-square tests in two-way contingency tables. However, in many situations it is impossible to use large-sample approximations to sampling distributions when theiradequacy can be in doubt. It is known, that these approximations may be very poor when the contingency table contains very small expected frequencies. However, recent work has shown that these approximations can be very poor when the contingency table contains both small and large expected frequencies. Of course, the rule of thumb of a minimum expected frequency is not met either in the case of sparse table. The article deals with alternative approaches to the data analysis in such cases. It points out other possibilities and shows that thanks to the development of computer technology exact methods previously only difficult usable are available for this purpose.

Complementary and alternative medicine for the treatment of bronchiolitis in infants: A systematic review.

Science.gov (United States)

Kua, Kok Pim; Lee, Shaun Wen Huey

2017-01-01

Bronchiolitis is a common cause of hospitalization among infants. The limited effectiveness of conventional medication has prompted the use of complementary and alternative medicine (CAM) as alternative or adjunctive therapy for the management of bronchiolitis. To determine the effectiveness and safety of CAM for the treatment of bronchiolitis in infants aged less than 2 years. A systematic electronic search was performed in Medline, Embase, CINAHL, AMED, and Cochrane Central Register of Controlled Trials (CENTRAL) from their respective inception to June 30, 2016 for studies evaluating CAM as an intervention to treat bronchiolitis in infants (1 month to 2 years of age). The CAM could be any form of treatment defined by the National Center for Complementary and Integrative Health (NCCIH) and was utilized either as a single agent or adjunctive therapy. The predefined primary outcome was length of hospital stay. Secondary outcomes were time to resolution of bronchiolitis symptoms, adverse events, and all other clinical outcomes reported by the included studies. The review identified 11 studies (8 randomized controlled trials and 3 cohort studies) examining four herbal preparations and four supplements used either as adjunctive or alternative therapy for bronchiolitis in 904 infants. Most studies were of moderate quality. Among six studies reporting on length of stay, a significant benefit was found for Chinese herbal medicine compared to ribavirin in one cohort study (n = 66) and vitamin D compared to placebo in one randomized controlled trial (n = 89). Studies of Chinese herbal medicine (4 studies, n = 365), vitamin D (1 study, n = 89), N-acetylcysteine (1 study, n = 100), and magnesium (2 studies, n = 176) showed some benefits with respect to clinical severity scores, oxygen saturation, and other symptoms, although data were sparse for any single intervention and the outcomes assessed and reported varied across studies. Only five studies reported on adverse events

Cost-effectiveness of cell salvage and alternative methods of minimising perioperative allogeneic blood transfusion: a systematic review and economic model.

Science.gov (United States)

Davies, L; Brown, T J; Haynes, S; Payne, K; Elliott, R A; McCollum, C

2006-11-01

To compare patient outcomes, resource use and costs to the NHS and NHS Blood Transfusion Authority (BTA) associated with cell salvage and alternative methods of minimising perioperative allogeneic blood transfusion. Electronic databases covering the period 1996-2004 for systematic reviews and 1994-2004 for economic evidence. Existing systematic reviews were updated with data from selected randomised controlled trials (RCTs) that involved adults scheduled for elective non-urgent surgery. Any resource use or cost data were extracted for potential use in populating an economic model. Relative risks or weighted mean difference of each outcome for each intervention were assessed, taking into account the number of RCTs included in each outcome and intervention and the presence of any heterogeneity. This allowed indirect comparison of the relative effectiveness of each intervention when the intervention is compared with allogeneic blood transfusion. A decision analytic model synthesised clinical and economic data from several sources, to estimate the relative cost-effectiveness of cell salvage for people undergoing elective surgery with moderate to major expected blood loss. The perspective of the NHS and patients and a time horizon of 1 month were used. The economic model was developed from reviews of effectiveness and cost-effectiveness and clinical experts. Secondary analysis explored the robustness of the results to changes in the timing and costs of cell salvage equipment, surgical procedure, use of transfusion protocols and time horizon of analysis. Overall, 668 studies were identified electronically for the update of the two systematic reviews. This included five RCTs, of which two were cell salvage and three preoperative autologous donation (PAD). Five published systematic reviews were identified for antifibrinolytics, fibrin sealants and restrictive transfusion triggers, PAD plus erythropoietin, erythropoietin alone and acute normovolaemic haemodilution (ANH

A systematic indoor air quality audit approach for public buildings.

Science.gov (United States)

Asadi, Ehsan; da Silva, Manuel C Gameiro; Costa, J J

2013-01-01

Good indoor air quality (IAQ) in buildings provides a comfortable and healthy environment for the occupants to work, learn, study, etc. Therefore, it is important to ascertain the IAQ status in the buildings. This study is aimed to establish and demonstrate the comprehensive IAQ audit approach for public buildings, based on Portugal national laws. Four public buildings in Portugal are used to demonstrate the IAQ audit application. The systematic approach involves the measurement of physical parameters (temperature, relative humidity, and concentration of the suspended particulate matter), monitoring of the concentrations of selected chemical indicators [carbon dioxide (CO(2)), carbon monoxide, formaldehyde, ozone, and total volatile organic compounds], and the measurements of biological indicators (bacteria and fungi). In addition, air exchange rates are measured by the concentration decay method using metabolic CO(2) as the tracer gas. The comprehensive audits indicated some situations of common IAQ problems in buildings, namely: (1) insufficient ventilation rate, (2) too high particle concentration; and (3) poor filtration effectiveness and hygienic conditions in most of the air handling units. Accordingly, a set of recommendations for the improvement of IAQ conditions were advised to the building owner/managers.

An alternative approach to the management of reactive metals: tolerant cementitious systems

International Nuclear Information System (INIS)

Swift, P.; Cox, J.; Wise, M.; McKinney, J.; Rhodes, C.

2015-01-01

In recent years research has focused on preventing or minimising corrosion of reactive metals to ensure long-term waste package integrity. An alternative approach to the encapsulation of reactive metals is being explored. The approach will identify a cementitious-based encapsulating material that will allow corrosion of reactive metals to occur in a controlled and predictable manner, rather than seeking to limit or prevent the corrosion, whilst retaining waste package integrity. A low strength grout will be developed that will be 'tolerant' to the expansive forces generated by the corrosion products of reactive metals. Novel cementitious systems (e.g. foamed cements, rubber composite cements, cenosphere composite cements, lime mortars, bentonite cements etc.) that may be tolerant to potentially expansive waste products, such as reactive metals will be considered and assessed in a series of small-scale preliminary trials (compressive strength, porosity, permeability, pore solution pH, etc.)

A Systematic Approach for Solving the Great Circle Track Problems based on Vector Algebra

Directory of Open Access Journals (Sweden)

Chen Chih-Li

2016-04-01

Full Text Available A systematic approach, based on multiple products of the vector algebra (S-VA, is proposed to derive the spherical triangle formulae for solving the great circle track (GCT problems. Because the mathematical properties of the geometry and algebra are both embedded in the S-VA approach, derivations of the spherical triangle formulae become more understandable and more straightforward as compared with those approaches which use the complex linear combination of a vector basis. In addition, the S-VA approach can handle all given initial conditions for solving the GCT problems simpler, clearer and avoid redundant formulae existing in the conventional approaches. With the technique of transforming the Earth coordinates system of latitudes and longitudes into the Cartesian one and adopting the relative longitude concept, the concise governing equations of the S-VA approach can be easily and directly derived. Owing to the advantage of the S-VA approach, it makes the practical navigator quickly adjust to solve the GCT problems. Based on the S-VA approach, a program namely GCTPro_VA is developed for friendly use of the navigator. Several validation examples are provided to show the S-VA approach is simple and versatile to solve the GCT problems.

Systematic mechanism-orientated approach to chronic pancreatitis pain.

Science.gov (United States)

Bouwense, Stefan A W; de Vries, Marjan; Schreuder, Luuk T W; Olesen, Søren S; Frøkjær, Jens B; Drewes, Asbjørn M; van Goor, Harry; Wilder-Smith, Oliver H G

2015-01-07

Pain in chronic pancreatitis (CP) shows similarities with other visceral pain syndromes (i.e., inflammatory bowel disease and esophagitis), which should thus be managed in a similar fashion. Typical causes of CP pain include increased intrapancreatic pressure, pancreatic inflammation and pancreatic/extrapancreatic complications. Unfortunately, CP pain continues to be a major clinical challenge. It is recognized that ongoing pain may induce altered central pain processing, e.g., central sensitization or pro-nociceptive pain modulation. When this is present conventional pain treatment targeting the nociceptive focus, e.g., opioid analgesia or surgical/endoscopic intervention, often fails even if technically successful. If central nervous system pain processing is altered, specific treatment targeting these changes should be instituted (e.g., gabapentinoids, ketamine or tricyclic antidepressants). Suitable tools are now available to make altered central processing visible, including quantitative sensory testing, electroencephalograpy and (functional) magnetic resonance imaging. These techniques are potentially clinically useful diagnostic tools to analyze central pain processing and thus define optimum management approaches for pain in CP and other visceral pain syndromes. The present review proposes a systematic mechanism-orientated approach to pain management in CP based on a holistic view of the mechanisms involved. Future research should address the circumstances under which central nervous system pain processing changes in CP, and how this is influenced by ongoing nociceptive input and therapies. Thus we hope to predict which patients are at risk for developing chronic pain or not responding to therapy, leading to improved treatment of chronic pain in CP and other visceral pain disorders.

Multidisciplinary approaches to managing osteoarthritis in multiple joint sites: a systematic review.

Science.gov (United States)

Finney, Andrew; Healey, Emma; Jordan, Joanne L; Ryan, Sarah; Dziedzic, Krysia S

2016-07-08

The National Institute for Health and Care Excellence's Osteoarthritis (OA) guidelines recommended that future research should consider the benefits of combination therapies in people with OA across multiple joint sites. However, the clinical effectiveness of such approaches to OA management is unknown. This systematic review therefore aimed to identify the clinical and cost effectiveness of multidisciplinary approaches targeting multiple joint sites for OA in primary care. A systematic review of randomised controlled trials. Computerised bibliographic databases were searched (MEDLINE, EMBASE, CINAHL, PsychINFO, BNI, HBE, HMIC, AMED, Web of Science and Cochrane). Studies were included if they met the following criteria; a randomised controlled trial (RCT), a primary care population with OA across at least two different peripheral joint sites (multiple joint sites), and interventions undertaken by at least two different health disciplines (multidisciplinary). The Cochrane 'Risk of Bias' tool and PEDro were used for quality assessment of eligible studies. Clinical and cost effectiveness was determined by extracting and examining self-reported outcomes for pain, function, quality of life (QoL) and health care utilisation. The date range for the search was from database inception until August 2015. The search identified 1148 individual titles of which four were included in the review. A narrative review was conducted due to the heterogeneity of the included trials. Each of the four trials used either educational or exercise interventions facilitated by a range of different health disciplines. Moderate clinical benefits on pain, function and QoL were reported across the studies. The beneficial effects of exercise generally decreased over time within all studies. Two studies were able to show a reduction in healthcare utilisation due to a reduction in visits to a physiotherapist or a reduction in x-rays and orthopaedic referrals. The intervention that showed the most

Mental disorders frequency alternative and complementary ...

African Journals Online (AJOL)

2014-05-01

May 1, 2014 ... This study is to determine the prevalence of mental disorders among patients diagnosed ... Key words: Alternative medicine, diabetes mellitus, hypertension, mental disorder ..... Engum A, Mykletun A, Midthjell K, Holen A, Dahl AA. ... or undiagnosed diabetes: A systematic review and meta‑analysis of the.

CT evaluation of soft tissue and muscle infection and inflammation: A systematic compartmental approach

Energy Technology Data Exchange (ETDEWEB)

Beauchamp, N.J. Jr. [Dept. of Radiology, and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Scott, W.W. Jr. [Dept. of Radiology, and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Gottlieb, L.M. [Dept. of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Fishman, E.K. [Dept. of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD (United States)

1995-07-01

This essay presents a systematic approach to the evaluation of soft tissue and muscle infection by defining the various pathologic processes and then illustrating them through a series of CT studies with corresponding schematic diagrams. The specific processes discussed are cellulitis, lymphangitis/lymphedema, necrotizing fascitis, myositis/myonecrosis, and abscess. Key points in the differential diagnosis of these entities are discussed and illustrated. The clinical management of the specific pathologic processes is also discussed. (orig./MG)

CT evaluation of soft tissue and muscle infection and inflammation: A systematic compartmental approach

International Nuclear Information System (INIS)

Beauchamp, N.J. Jr.; Scott, W.W. Jr.; Gottlieb, L.M.; Fishman, E.K.

1995-01-01

This essay presents a systematic approach to the evaluation of soft tissue and muscle infection by defining the various pathologic processes and then illustrating them through a series of CT studies with corresponding schematic diagrams. The specific processes discussed are cellulitis, lymphangitis/lymphedema, necrotizing fascitis, myositis/myonecrosis, and abscess. Key points in the differential diagnosis of these entities are discussed and illustrated. The clinical management of the specific pathologic processes is also discussed. (orig./MG)

Drug repurposing: a systematic approach to evaluate candidate oral neuroprotective interventions for secondary progressive multiple sclerosis.

Directory of Open Access Journals (Sweden)

Hanna M Vesterinen

Full Text Available To develop and implement an evidence based framework to select, from drugs already licenced, candidate oral neuroprotective drugs to be tested in secondary progressive multiple sclerosis.Systematic review of clinical studies of oral putative neuroprotective therapies in MS and four other neurodegenerative diseases with shared pathological features, followed by systematic review and meta-analyses of the in vivo experimental data for those interventions. We presented summary data to an international multi-disciplinary committee, which assessed each drug in turn using pre-specified criteria including consideration of mechanism of action.We identified a short list of fifty-two candidate interventions. After review of all clinical and pre-clinical evidence we identified ibudilast, riluzole, amiloride, pirfenidone, fluoxetine, oxcarbazepine, and the polyunsaturated fatty-acid class (Linoleic Acid, Lipoic acid; Omega-3 fatty acid, Max EPA oil as lead candidates for clinical evaluation.We demonstrate a standardised and systematic approach to candidate identification for drug rescue and repurposing trials that can be applied widely to neurodegenerative disorders.

A systematic review of approaches to refeeding in patients with anorexia nervosa.

Science.gov (United States)

Garber, Andrea K; Sawyer, Susan M; Golden, Neville H; Guarda, Angela S; Katzman, Debra K; Kohn, Michael R; Le Grange, Daniel; Madden, Sloane; Whitelaw, Melissa; Redgrave, Graham W

2016-03-01

Given the importance of weight restoration for recovery in patients with anorexia nervosa (AN), we examined approaches to refeeding in adolescents and adults across treatment settings. Systematic review of PubMed, PsycINFO, Scopus, and Clinical Trials databases (1960-2015) using terms refeeding, weight restoration, hypophosphatemia, anorexia nervosa, anorexia, and anorexic. Of 948 screened abstracts, 27 met these inclusion criteria: participants had AN; reproducible refeeding approach; weight gain, hypophosphatemia or cognitive/behavioral outcomes. Twenty-six studies (96%) were observational/prospective or retrospective and performed in hospital. Twelve studies published since 2010 examined approaches starting with higher calories than currently recommended (≥1400 kcal/d). The evidence supports 8 conclusions: 1) In mildly and moderately malnourished patients, lower calorie refeeding is too conservative; 2) Both meal-based approaches or combined nasogastric+meals can administer higher calories; 3) Higher calorie refeeding has not been associated with increased risk for the refeeding syndrome under close medical monitoring with electrolyte correction; 4) In severely malnourished inpatients, there is insufficient evidence to change the current standard of care; 5) Parenteral nutrition is not recommended; 6) Nutrient compositions within recommended ranges are appropriate; 7) More research is needed in non-hospital settings; 8) The long-term impact of different approaches is unknown; Findings support higher calorie approaches to refeeding in mildly and moderately malnourished patients under close medical monitoring, however the safety, long-term outcomes, and feasibility outside of hospital have not been established. Further research is also needed on refeeding approaches in severely malnourished patients, methods of delivery, nutrient compositions and treatment settings. © 2015 Wiley Periodicals, Inc.

A systematic approach to the training in the nuclear power industry: The need for standard

International Nuclear Information System (INIS)

Wilkinson, J.D.

1995-01-01

The five elements of a open-quotes Systematic Approach to Trainingclose quotes (SAT) are analysis, design, development, implementation and evaluation. These elements are also present in the effective application of basic process control. The fundamental negative feedback process control loop is therefore an excellent model for a successful, systematic approach to training in the nuclear power industry. Just as standards are required in today's manufacturing and service industries, eg ISO 9000, so too are control standards needed in the training industry and in particular in the training of nuclear power plant staff. The International Atomic Energy Agency (IAEA) produced its TECDOC 525 on open-quotes Training to Establish and Maintain the Qualification and Competence of Nuclear Power Plant Operations Personnelclose quotes in 1989 and the American Nuclear Society published its open-quotes Selection, Qualification, and Training of Personnel for Nuclear Power Plants, an American National Standardclose quotes in 1993. It is important that community colleges, training vendors and organizations such as the Instrument Society of America (ISA), who may be supplying basic or prerequisite training to the nuclear power industry, become aware of these and other standards relating to training in the nuclear power industry

A systematic policy approach to changing the food system and physical activity environments to prevent obesity.

Science.gov (United States)

Sacks, Gary; Swinburn, Boyd A; Lawrence, Mark A

2008-06-05

As obesity prevention becomes an increasing health priority in many countries, including Australia and New Zealand, the challenge that governments are now facing is how to adopt a systematic policy approach to increase healthy eating and regular physical activity. This article sets out a structure for systematically identifying areas for obesity prevention policy action across the food system and full range of physical activity environments. Areas amenable to policy intervention can be systematically identified by considering policy opportunities for each level of governance (local, state, national, international and organisational) in each sector of the food system (primary production, food processing, distribution, marketing, retail, catering and food service) and each sector that influences physical activity environments (infrastructure and planning, education, employment, transport, sport and recreation). Analysis grids are used to illustrate, in a structured fashion, the broad array of areas amenable to legal and regulatory intervention across all levels of governance and all relevant sectors. In the Australian context, potential regulatory policy intervention areas are widespread throughout the food system, e.g., land-use zoning (primary production within local government), food safety (food processing within state government), food labelling (retail within national government). Policy areas for influencing physical activity are predominantly local and state government responsibilities including, for example, walking and cycling environments (infrastructure and planning sector) and physical activity education in schools (education sector). The analysis structure presented in this article provides a tool to systematically identify policy gaps, barriers and opportunities for obesity prevention, as part of the process of developing and implementing a comprehensive obesity prevention strategy. It also serves to highlight the need for a coordinated approach to

Alternative Approaches to Food: Community Supported Agriculture in Urban China

Directory of Open Access Journals (Sweden)

Kees Krul

2017-05-01

Full Text Available One of the most remarkable features of China’s development path is its large-scale and fast-paced urbanization. As cities already accommodate more than half of China’s population, new challenges to urban food systems have emerged concurrently. Concerns over environmental degradation and food safety have provoked growing dissatisfaction with China’s food regime. Amidst these concerns, the aim of this paper is to study the role of new and alternative approaches to food, focusing in on the question of how community supported agriculture (CSA can deal with the food-related issues emerging from China’s development. The paper adopts Granovetter’s notions of social embeddedness to describe CSA’s relational role in consumer-farmer dynamics, as well as the structural role within its broader relational context. Empirical data is drawn from surveys distributed among CSA farms, and interviews with key stakeholders in the Chinese CSA movement. The study finds that the model of CSA demonstrates an innovative approach to deal with food safety issues, address sustainability, and operate in an environment where future food demands are most critical. Although the movement’s structural embeddedness is bound by several limitations and contradictions, it is argued that the CSA model offers important insights and adds value into ameliorating China’s food systems.

Human interest meets biodiversity hotspots: A new systematic approach for urban ecosystem conservation.

Science.gov (United States)

Kasada, Minoru; Matsuba, Misako; Miyashita, Tadashi

2017-01-01

Creating a win-win relationship between biodiversity and human well-being is one of the major current challenges for environmental policy. One way to approach this challenge is to identify sites with both high biodiversity and high human interest in urban areas. Here, we propose a new systematic approach to identify such sites by using land prices and biodiversity indexes for butterflies and birds from a nationwide perspective. As a result, we found sites that are valuable to humans and to other organisms, including national red-list species, and they are located in sites with cultural heritages and near seaside. By referencing the habitat features and landscape characteristics of these sites, we can establish high quality environments that provide a benefit to both humans and biodiversity in urban landscapes.

Integrating Exposure into Chemical Alternatives Assessment Using a Qualitative Approach

Science.gov (United States)

Most alternatives assessments (AA) published to date are largely hazard-based rankings, and as such may not represent a fully informed consideration of the advantages and disadvantages of possible alternatives. With an assessment goal of identifying an alternative chemical that i...

The Systematic Approach to Training: Analysis and Evaluation in the Department of Safeguards

International Nuclear Information System (INIS)

Ticevic, S.; Weichselbraun, A.; Pickett, S.; Crete, J.-M.

2015-01-01

In applying a systematic approach to training (SAT), identifying the learning needs is the first step - a learning needs analysis allows the organization to identify the competencies required to perform a particular job. A systematic approach can provide a clear structure for training and education programme development as well as the necessary evaluation and feedback so that the organization can adjust the development accordingly and deliver the optimal learning experience. In this presentation we will describes two key elements of a SAT used in the Safeguards Training Section in the Department of Safeguards: Analysis and Evaluation. Analysis is the first part of a SAT needed to define competencies for Safeguards staff in order to improve training development within the Department. We describe the training needs analysis used to capture and articulate the various competencies required for safeguards implementation based upon an analysis of tasks and activities carried out by staff members in the Department. Firstly, we highlight the different qualitative methods used to gather information from staff and the process of evaluating and organizing this information into a structured framework. Secondly, we describe how this framework provides the necessary reference to specify learning objectives, evaluate training effectiveness, review and revise training offerings, and select appropriate training paths based on identified needs. In addition, as part of the SAT, evaluation is performed to identify the usefulness of course outcomes and improvements for future offerings based on lessons learned, to ensure that appropriate knowledge and skills are being taught and to demonstrate the value of training by meeting the organization's needs. We present how the Kirkpatrick four-level evaluation model has been implemented by Safeguards Training Section in order to evaluate course effectiveness after the training has been completed, and discuss how the current evaluation

A Systematic Approach to Determining the Identifiability of Multistage Carcinogenesis Models.

Science.gov (United States)

Brouwer, Andrew F; Meza, Rafael; Eisenberg, Marisa C

2017-07-01

Multistage clonal expansion (MSCE) models of carcinogenesis are continuous-time Markov process models often used to relate cancer incidence to biological mechanism. Identifiability analysis determines what model parameter combinations can, theoretically, be estimated from given data. We use a systematic approach, based on differential algebra methods traditionally used for deterministic ordinary differential equation (ODE) models, to determine identifiable combinations for a generalized subclass of MSCE models with any number of preinitation stages and one clonal expansion. Additionally, we determine the identifiable combinations of the generalized MSCE model with up to four clonal expansion stages, and conjecture the results for any number of clonal expansion stages. The results improve upon previous work in a number of ways and provide a framework to find the identifiable combinations for further variations on the MSCE models. Finally, our approach, which takes advantage of the Kolmogorov backward equations for the probability generating functions of the Markov process, demonstrates that identifiability methods used in engineering and mathematics for systems of ODEs can be applied to continuous-time Markov processes. © 2016 Society for Risk Analysis.

A comparison of mainline and alternate approaches to fusion energy

International Nuclear Information System (INIS)

Hayman, P.W.; Roth, J.R.

1985-01-01

The tokamak and tandem mirror concepts are compared with alternate confinement concepts using the criteria established in DOE/ET-0047, ''An Evaluation of Alternate Magnetic Fusion Concepts 1977.'' The concepts are evaluated and rated in each of three broad categories: confidence in physics and technology, and reactor desirability. The STARFIRE and MARS reactors are used as a basis for comparing the mainline tokamak and tandem mirror concepts with the alternate concepts evaluated in DOE/ET-0047. Two recent alternate concepts, the ohmically heated toroidal experiment (OHTE) and the compact reversed field pinch reactor (CRFPR), are also evaluated. Results indicate that the physics of the mainline tokamaks and tandem mirrors is better understood than that of most alternate concepts. Both mainline concepts rank near the middle for technology requirements, and both rank near or at the bottom when compared with the reactor desirability of alternate concepts

Systematic approach to preparing ceramic-glass composites with high translucency for dental restorations.

Science.gov (United States)

Yoshimura, Humberto N; Chimanski, Afonso; Cesar, Paulo F

2015-10-01

Ceramic composites are promising materials for dental restorations. However, it is difficult to prepare highly translucent composites due to the light scattering that occurs in multiphase ceramics. The objective of this work was to verify the effectiveness of a systematic approach in designing specific glass compositions with target properties in order to prepare glass infiltrated ceramic composites with high translucency. First it was necessary to calculate from literature data the viscosity of glass at the infiltration temperature using the SciGlass software. Then, a glass composition was designed for targeted viscosity and refractive index. The glass of the system SiO2-B2O3-Al2O3-La2O3-TiO2 prepared by melting the oxide raw materials was spontaneously infiltrated into porous alumina preforms at 1200°C. The optical properties were evaluated using a refractometer and a spectrophotometer. The absorption and scattering coefficients were calculated using the Kubelka-Munk model. The light transmittance of prepared composite was significantly higher than a commercial ceramic-glass composite, due to the matching of glass and preform refractive indexes which decreased the scattering, and also to the decrease in absorption coefficient. The proposed systematic approach was efficient for development of glass infiltrated ceramic composites with high translucency, which benefits include the better aesthetic performance of the final prosthesis. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Emission Control Cost-Effectiveness of Alternative-Fuel Vehicles

OpenAIRE

Wang, Quanlu; Sperling, Daniel; Olmstead, Janis

1993-01-01

Although various legislation and regulations have been adopted to promote the use of alternative-fuel vehicles for curbing urban air pollution problems, there is a lack of systematic comparisons of emission control cost-effectiveness among various alternative-fuel vehicle types. In this paper, life-cycle emission reductions and life-cycle costs were estimated for passenger cars fueled with methanol, ethanol, liquified petroleum gas, compressed natural gas, and electricity. Vehicle emission es...

The Political Construction of Alternative Dispute Resolution and Alternatives to Incarceration.

Science.gov (United States)

Palumbo, Dennis J.; And Others

1994-01-01

This discussion of evaluations of mediation programs at seven sites and of shock incarceration and home arrest focuses on the similarities in the interpretations of alternative dispute-resolution programs to interpretations of alternatives to incarceration programs. The political construction of the two approaches, which are both designed to…

A new approach in nuclear risk theory

International Nuclear Information System (INIS)

Serbanescu, D.

1994-01-01

The basic problem of the probabilistic safety assessment (PSA) is the errors evaluation. The main contributor to the final PSA results is the systematical error induced by the method itself. There may be some alternatives to the PSA classical approaches. All the new more successful approaches in the PSA results validation are related to the modelling problem. A comparison between two possible approaches for a pressurized heavy water reactor (PHWR) leakage event tree is included: The new approach proposed in (Serbanescu, 1991); the approach used in (Serbanescu, 1992), based on some unexplored yet features of the existing PSA analyses. The results are presented in relative units and an algorithm which was already implemented on an IBM.PC computer (Serbanescu, 1991) is used as a tool to decisions making tool. The decision making process should be based on a nuclear power plant (NPP) between modelling from the risk analysis point of view. This is the main feature of the proposed approach. (author). 4 refs, 2 figs, 2 tabs

Interpretation of computed tomography imaging of the eye and orbit. A systematic approach

Directory of Open Access Journals (Sweden)

Naik Milind

2002-01-01

Full Text Available Computed tomography (CT has revolutionised the diagnosis and management of ocular and orbital diseases. The use of thin sections with multiplanar scanning (axial, coronal and sagittal planes and the possibility of three-dimensional reconstruction permits thorough evaluation. To make the most of this technique, users must familiarize themselves with the pertinent CT principles and terminology. The diagnostic yield is optimal when the ophthalmologist and radiologist collaborate in the radiodiagnostic workup. In this article we describe a systematic approach to the interpretation of ocular and orbital CT scans.

Alternative approaches for better municipal solid waste management in Mumbai, India

International Nuclear Information System (INIS)

Rathi, Sarika

2006-01-01

Waste is an unavoidable by product of human activities. Economic development, urbanization and improving living standards in cities, have led to an increase in the quantity and complexity of generated waste. Rapid growth of population and industrialization degrades the urban environment and places serious stress on natural resources, which undermines equitable and sustainable development. Inefficient management and disposal of solid waste is an obvious cause of degradation of the environment in most cities of the developing world. Municipal corporations of the developing countries are not able to handle increasing quantities of waste, which results in uncollected waste on roads and in other public places. There is a need to work towards a sustainable waste management system, which requires environmental, institutional, financial, economic and social sustainability. This study explores alternative approaches to municipal solid waste (MSW) management and estimates the cost of waste management in Mumbai, India. Two alternatives considered in the paper are community participation and public private partnership in waste management. Data for the present study are from various non-governmental organizations (NGOs) and from the private sector involved in waste management in Mumbai. Mathematical models are used to estimate the cost per ton of waste management for both of the alternatives, which are compared with the cost of waste management by Municipal Corporation of Greater Mumbai (MCGM). It is found that the cost per ton of waste management is Rs. 1518 (US$35) with community participation; Rs. 1797 (US$41) with public private partnership (PPP); and Rs. 1908 (US$44) when only MCGM handles the waste. Hence, community participation in waste management is the least cost option and there is a strong case for comprehensively involving community participation in waste management

Systematic approach to training for competence building in radiation safety

International Nuclear Information System (INIS)

Asiamah, S.D.; Schandorf, C.; Darko, E.O.

2003-01-01

Competence building involves four main attributes, namely, knowledge, skills, operating experience and attitude to radiation safety. These multi-attribute requirements demand a systematic approach to education and training of regulatory staff, licensees/registrants and service providers to ensure commensurate competence in performance of responsibilities and duties to specified standards. In order to address issues of competencies required in radiation safety a national programme for qualification and certification has been initiated for regulatory staff, operators, radiation safety officers and qualified experts. Since the inception of this programme in 1993, 40 training events have been organized involving 423 individuals. This programme is at various levels of implementation due to financial and human resource constraints. A department for Human Resource Development and Research was established in 2000 to enhance and ensure the sustainability of the effectiveness of capacity building in radiation safety. (author)

Treatment of secondary burn wound progression in contact burns-a systematic review of experimental approaches.

Science.gov (United States)

Schmauss, Daniel; Rezaeian, Farid; Finck, Tom; Machens, Hans-Guenther; Wettstein, Reto; Harder, Yves

2015-01-01

After a burn injury, superficial partial-thickness burn wounds may progress to deep partial-thickness or full-thickness burn wounds, if kept untreated. This phenomenon is called secondary burn wound progression or conversion. Burn wound depth is an important determinant of patient morbidity and mortality. Therefore, reduction or even the prevention of secondary burn wound progression is one goal of the acute care of burned patients. The objective of this study was to review preclinical approaches evaluating therapies to reduce burn wound progression. A systematic review of experimental approaches in animals that aim at reducing or preventing secondary burn wound progression was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. The selected references consist of all the peer-reviewed studies performed in vivo in animals and review articles published in English, German, Italian, Spanish, or French language relevant to the topic of secondary burn wound progression. We searched MEDLINE, Cochrane Library, and Google Scholar including all the articles published from the beginning of notations to the present. The search was conducted between May 3, 2012 and December 26, 2013. We included 29 experimental studies in this review, investigating agents that maintain or increase local perfusion conditions, as well as agents that exhibit an anti-coagulatory, an anti-inflammatory, or an anti-apoptotic property. Warm water, simvastatin, EPO, or cerium nitrate may represent particularly promising approaches for the translation into clinical use in the near future. This review demonstrates promising experimental approaches that might reduce secondary burn wound progression. Nevertheless, a translation into clinical application needs to confirm the results compiled in experimental animal studies.

Acute and long-term management of food allergy: systematic review.

Science.gov (United States)

de Silva, D; Geromi, M; Panesar, S S; Muraro, A; Werfel, T; Hoffmann-Sommergruber, K; Roberts, G; Cardona, V; Dubois, A E J; Halken, S; Host, A; Poulsen, L K; Van Ree, R; Vlieg-Boerstra, B J; Agache, I; Sheikh, A

2014-02-01

Allergic reactions to food can have serious consequences. This systematic review summarizes evidence about the immediate management of reactions and longer-term approaches to minimize adverse impacts. Seven bibliographic databases were searched from their inception to September 30, 2012, for systematic reviews, randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials, controlled before-and-after and interrupted time series studies. Experts were consulted for additional studies. There was no language or geographic restrictions. Two reviewers critically appraised the studies using the appropriate tools. Data were not suitable for meta-analysis due to heterogeneity so were narratively synthesized. Eighty-four studies were included, but two-thirds were at high risk of potential bias. There was little evidence about acute management for non-life-threatening reactions. H1-antihistamines may be of benefit, but this evidence was in part derived from studies on those with cross-reactive birch pollen allergy. Regarding long-term management, avoiding the allergenic food or substituting an alternative was commonly recommended, but apart from for infants with cow's milk allergy, there was little high-quality research on this management approach. To reduce symptoms in children with cow's milk allergy, there was evidence to recommend alternatives such as extensively hydrolyzed formula. Supplements such as probiotics have not proved helpful, but allergen-specific immunotherapy may be disease modifying and therefore warrants further exploration. Food allergy can be debilitating and affects a significant number of people. However, the evidence base about acute and longer-term management is weak and needs to be strengthened as a matter of priority. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

What do Cochrane systematic reviews say about non-surgical interventions for urinary incontinence in women?

Directory of Open Access Journals (Sweden)

Anderson Adriano Leal Freitas da Costa

Full Text Available ABSTRACT BACKGROUND: Urinary incontinence is a highly prevalent condition that impacts self-esteem and overall quality of life. Many non-surgical treatment options are available, ranging from pharmacological approaches to pelvic exercises. We aimed to summarize the available evidence regarding these non-surgical interventions. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP. METHODS: A sensitive search was conducted to identify all Cochrane systematic reviews that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. RESULTS: We included 20 Cochrane systematic reviews: 4 assessing methods of vesical training, 3 evaluating pharmacological interventions, 4 studying pelvic floor muscle training approaches and 9 aimed at other alternatives (such as urethral injections, weighted vaginal cone use, acupuncture, biostimulation and radiofrequency therapy. The reviews found that the evidence regarding the benefits of these diverse interventions ranged in quality from low to high. CONCLUSIONS: This review included 20 Cochrane systematic reviews that provided evidence (of diverse quality for non-pharmacological interventions for patients with urinary incontinence. Moderate to high quality of evidence was found favoring the use of pelvic floor muscle training among women with urinary incontinence. To establish solid conclusions for all the other comparisons, further studies of good methodological quality are needed.

The ChemScreen project to design a pragmatic alternative approach to predict reproductive toxicity of chemicals

DEFF Research Database (Denmark)

van der Burg, Bart; Wedebye, Eva Bay; Dietrich, Daniel R.

2015-01-01

to validate the test panel using mechanistic approaches. We are actively engaged in promoting regulatory acceptance of the tools developed as an essential step towards practical application, including case studies for read-across purposes. With this approach, a significant saving in animal use and associated......There is a great need for rapid testing strategies for reproductive toxicity testing, avoiding animal use. The EU Framework program 7 project ChemScreen aimed to fill this gap in a pragmatic manner preferably using validated existing tools and place them in an innovative alternative testing...

Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare.

Science.gov (United States)

Lennox, L; Maher, L; Reed, J

2018-02-09

Improvement initiatives offer a valuable mechanism for delivering and testing innovations in healthcare settings. Many of these initiatives deliver meaningful and necessary changes to patient care and outcomes. However, many improvement initiatives fail to sustain to a point where their full benefits can be realised. This has led many researchers and healthcare practitioners to develop frameworks, models and tools to support and monitor sustainability. This work aimed to identify what approaches are available to assess and influence sustainability in healthcare and to describe the different perspectives, applications and constructs within these approaches to guide their future use. A systematic review was carried out following PRISMA guidelines to identify publications that reported approaches to support or influence sustainability in healthcare. Eligibility criteria were defined through an iterative process in which two reviewers independently assessed 20% of articles to test the objectivity of the selection criteria. Data were extracted from the identified articles, and a template analysis was undertaken to identify and assess the sustainability constructs within each reported approach. The search strategy identified 1748 publications with 227 articles retrieved in full text for full documentary analysis. In total, 62 publications identifying a sustainability approach were included in this review (32 frameworks, 16 models, 8 tools, 4 strategies, 1 checklist and 1 process). Constructs across approaches were compared and 40 individual constructs for sustainability were found. Comparison across approaches demonstrated consistent constructs were seen regardless of proposed interventions, setting or level of application with 6 constructs included in 75% of the approaches. Although similarities were found, no approaches contained the same combination of the constructs nor did any single approach capture all identified constructs. From these results, a consolidated

A Systematic Mapping on Supporting Approaches for Requirements Traceability in the Context of Software Projects

Directory of Open Access Journals (Sweden)

MALCHER, P R.C.

2015-12-01

Full Text Available The Requirements Traceability is seen as a quality factor with regard to software development, being present in standards and quality models. In this context, several techniques, models, frameworks and tools have been used to support it. Thus, the purpose of this paper is to present a systematic mapping carried out in order to find in the literature approaches to support the requirements traceability in the context of software projects and make the categorization of the data found in order to demonstrate, by means of a reliable, accurate and auditable method, how this area has developed and what are the main approaches are used to implement it.

A First Case Study of a Life Cycle-Based Alternatives Assessment (LCAA)

DEFF Research Database (Denmark)

Fantke, Peter; Huang, L.; Overcash, Michael

2017-01-01

cycle impacts. Our approach is evaluated in a case study, through which we outline future research needs to fully operationalize a consistent and Life Cycle-based Alternatives Assessment (LCAA). We build on a flexible mass balance-based modeling system yielding cumulative multimedia transfer fractions...... and exposure pathway-specific Product Intake Fractions defined as chemical mass taken in by humans per unit mass of chemical in a product. When combined with chemical masses in products and further with toxicity information, this approach is a resourceful way to inform AA. Our case study reveals that replacing...... various population groups including workers, consumers and the general public, while life cycle impacts need to focus on categories relevant for a given AA chemical-product application. We systematically define the scope of AA and identify key elements for quantitatively considering exposure and life...

Alternative approach for management of an electrical storm in Brugada syndrome:Importance of primary ablation within a narrow time window

Directory of Open Access Journals (Sweden)

Ahmed Karim Talib, MD, PhD

2016-06-01

Full Text Available Placement of an implantable cardioverter–defibrillator (ICD is the only powerful treatment modality for Brugada syndrome in patients presenting with ventricular fibrillation (VF. For those whose first presentation is an electrical storm, pharmacologic therapy is typically used to control VF followed by ICD implantation. We report an alternative approach whereby, before ICD implantation, emergency catheter ablation of the VF-triggering premature ventricular contraction (PVC resulted in long-term VF-free survival. The results suggest that, because VF triggers appear in a narrow time window, ablation of the culprit PVCs that initiate VF before the index PVCs subside is a reasonable alternative approach.

A systematic approach to obtain validated Partial Least Square models for predicting lipoprotein subclasses from serum NMR spectra

NARCIS (Netherlands)

Mihaleva, V.V.; van Schalkwijk, D.B.; de Graaf, A.A.; van Duynhoven, J.; van Dorsten, F.A.; Vervoort, J.; Smilde, A.; Westerhuis, J.A.; Jacobs, D.M.

2014-01-01

A systematic approach is described for building validated PLS models that predict cholesterol and triglyceride concentrations in lipoprotein subclasses in fasting serum from a normolipidemic, healthy population. The PLS models were built on diffusion-edited 1H NMR spectra and calibrated on

A systematic approach to obtain validated partial least square models for predicting lipoprotein subclasses from serum NMR spectra

NARCIS (Netherlands)

Mihaleva, V.V.; Schalkwijk, van D.B.; Graaf, de A.A.; Duynhoven, van J.P.M.; Dorsten, van F.A.; Vervoort, J.J.M.; Smilde, A.K.; Westerhuis, J.A.; Jacobs, D.M.

2014-01-01

A systematic approach is described for building validated PLS models that predict cholesterol and triglyceride concentrations in lipoprotein subclasses in fasting serum from a normolipidemic, healthy population. The PLS models were built on diffusion-edited (1)H NMR spectra and calibrated on

A systematic approach to obtain validated partial least square models for predicting lipoprotein subclasses from serum nmr spectra

NARCIS (Netherlands)

Mihaleva, V.V.; Schalkwijk, D.B. van; Graaf, A.A. de; Duynhoven, J. van; Dorsten, F.A. van; Vervoort, J.; Smilde, A.; Westerhuis, J.A.; Jacobs, D.M.

2014-01-01

A systematic approach is described for building validated PLS models that predict cholesterol and triglyceride concentrations in lipoprotein subclasses in fasting serum from a normolipidemic, healthy population. The PLS models were built on diffusion-edited 1H NMR spectra and calibrated on

[A systematic review of the effectiveness of alternative weight-loss products' ingredients].

Science.gov (United States)

de Lira-García, Cynthia; Souto-Gallardo, María; Bacardí-Gascón, Monserrat; Jiménez-Cruz, Arturo

2008-01-01

The high demand for obesity treatment and conventional therapies' lack of effectiveness increases the use of alternative products. This study was aimed at assessing evidence from randomised clinical trials regarding the effectiveness of alternative weight-loss products' ingredients. A survey was conducted in Ensenada, Baja California, to assess the frequency of consuming alternative products used for weight reduction. The ingredients in the products most in demand were included in this review. The Pubmed database was searched for all randomised clinical trial papers including these ingredients and assessing weight loss. Thirty-six percent of the subjects questioned had used alternative methods for weight-loss, 83% of them being women. The most frequently used products were shakes, tea, pills and flaxseed/linseed. Sixteen randomised clinical trials using four ingredients were used: Garcinia cambogia, green tea, L-carnitina and flaxseed. Only two studies (green tea and Garcinia cambogia) showed significant weight-loss (25%) amongst control and experimental groups. There was no significant difference between the groups in the studies regarding L-carnitina and flaxseed. There is a lack of evidence regarding quality studies justifying the use of alternative products for weight loss.

Safety inspection guide, Mod III (a systematic approach to conducting a safety inspection)

International Nuclear Information System (INIS)

Davidson, J.E.

1977-06-01

This guide was developed as a comprehensive/systematic approach to the problem of performing a safety inspection. Five basic sections (categories) are considered in the guide: physical work place; machines/mechanical equipment; hazardous materials/processes/environments; energy sources; and management hazard . control factors. The basic concept is that one starts evaluating hazard potentials from the physical work place and continues considering other elements as they are added to the physical work place. This approach provides a better understanding of the interfaces of each section to the entire group. The guide is supported by an Area Safety Inspection Result form to record defects or conditions found, the evaluation (best estimate) of the urgency or priority for correcting deficiencies or areas of noncompliance, and the status of corrective action. Additionally, the guide serves as an educational tool in accident prevention for supervisors and employees

Impact significance determination-Designing an approach

International Nuclear Information System (INIS)

Lawrence, David P.

2007-01-01

The question of how best to go about determining the significance of impacts has, to date, only been addressed in a partial and preliminary way. The assumption tends to be made that it is either only necessary to provide explicit, justified reasons for a judgment about significance and/or to explicitly apply a prescribed procedure-a procedure usually involving the staged application of thresholds and/or criteria. The detailed attributes, strengths and limitations of such approaches and possible alternative approaches have yet to be explored systematically. This article addresses these deficiencies by analyzing the characteristics, specific methods and positive and negative tendencies of three general impact significance determination approaches-the technical approach, the collaborative approach and the reasoned argumentation approach. A range of potential composite approaches are also described. With an enhanced understanding of these approaches, together with potential combinations, EIA practitioners and other EIA participants can be in a better position to select an approach appropriate to their needs, to reinforce the positive tendencies and offset the negative tendencies of the selected approach and to combine the best qualities of more than one approach

Inverse Transformation: Unleashing Spatially Heterogeneous Dynamics with an Alternative Approach to XPCS Data Analysis.

Science.gov (United States)

Andrews, Ross N; Narayanan, Suresh; Zhang, Fan; Kuzmenko, Ivan; Ilavsky, Jan

2018-02-01

X-ray photon correlation spectroscopy (XPCS), an extension of dynamic light scattering (DLS) in the X-ray regime, detects temporal intensity fluctuations of coherent speckles and provides scattering vector-dependent sample dynamics at length scales smaller than DLS. The penetrating power of X-rays enables probing dynamics in a broad array of materials with XPCS, including polymers, glasses and metal alloys, where attempts to describe the dynamics with a simple exponential fit usually fails. In these cases, the prevailing XPCS data analysis approach employs stretched or compressed exponential decay functions (Kohlrausch functions), which implicitly assume homogeneous dynamics. In this paper, we propose an alternative analysis scheme based upon inverse Laplace or Gaussian transformation for elucidating heterogeneous distributions of dynamic time scales in XPCS, an approach analogous to the CONTIN algorithm widely accepted in the analysis of DLS from polydisperse and multimodal systems. Using XPCS data measured from colloidal gels, we demonstrate the inverse transform approach reveals hidden multimodal dynamics in materials, unleashing the full potential of XPCS.

Systematic review

DEFF Research Database (Denmark)

Enggaard, Helle

Title: Systematic review a method to promote nursing students skills in Evidence Based Practice Background: Department of nursing educate students to practice Evidence Based Practice (EBP), where clinical decisions is based on the best available evidence, patient preference, clinical experience...... and resources available. In order to incorporate evidence in clinical decisions, nursing students need to learn how to transfer knowledge in order to utilize evidence in clinical decisions. The method of systematic review can be one approach to achieve this in nursing education. Method: As an associate lecturer...... I have taken a Comprehensive Systematic Review Training course provide by Center of Clinical Guidelines in Denmark and Jonna Briggs Institute (JBI) and practice in developing a systematic review on how patients with ischemic heart disease experiences peer support. This insight and experience...

Compliance with the Dietary Approaches to Stop Hypertension (DASH diet: a systematic review.

Directory of Open Access Journals (Sweden)

Mandy Wing-Man Kwan

Full Text Available BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH diet has been recognized as effective to lower blood pressure in feeding trials, but compliance with the diet must be persistent to maximize health benefits in clinical practice. This paper reports a systematic review of the latest evidence on the method to assess DASH compliance and the corresponding patients' compliance in interventional settings. METHODS: The databases including MEDLINE, EBM Reviews, EMBASE, and CINAHL Plus were searched for original research studies published in the period of January 1992-December 2012 that evaluated compliance with DASH diet. Studies written in English language, with DASH intervention, with complete documentation of the degree of DASH compliance and the assessment method used were included in this review. The search terms included: dietary approaches to stop hypertension, DASH, compliance, adherence, consistency, and concordance. RESULTS: Nine studies were included. Different types of interventions were identified, ranging from feeding trial to dietary counseling. These studies differed in the assessment methods used to evaluate DASH compliance, which included objective approaches like measurement of urinary excretion, and subjective approaches like dietary intake assessment for DASH target comparison and construction of DASH scoring systems. Compliance levels were lower in educational interventions than that of the original DASH feeding trial. CONCLUSIONS: To conclude, although no consensus existed regarding the best approach to assess DASH compliance, its suboptimal compliance warrants attention. This study implied a need to investigate effective approaches to sustain the DASH dietary pattern beyond counselling alone.

e-Government Maturity Model Based on Systematic Review and Meta-Ethnography Approach

Directory of Open Access Journals (Sweden)

Darmawan Napitupulu

2016-11-01

Full Text Available Maturity model based on e-Government portal has been developed by a number of researchers both individually and institutionally, but still scattered in various journals and conference articles and can be said to have a different focus with each other, both in terms of stages and features. The aim of this research is conducting a study to integrate a number of maturity models existing today in order to build generic maturity model based on e-Government portal. The method used in this study is Systematic Review with meta-ethnography qualitative approach. Meta-ethnography, which is part of Systematic Review method, is a technique to perform data integration to obtain theories and concepts with a new level of understanding that is deeper and thorough. The result obtained is a maturity model based on e-Government portal that consists of 7 (seven stages, namely web presence, interaction, transaction, vertical integration, horizontal integration, full integration, and open participation. These seven stages are synthesized from the 111 key concepts related to 25 studies of maturity model based e-Government portal. The maturity model resulted is more comprehensive and generic because it is an integration of models (best practices that exists today.

Dynamics of single-bubble sonoluminescence. An alternative approach to the Rayleigh-Plesset equation

Science.gov (United States)

de Barros, Ana L. F.; Nogueira, Álvaro L. M. A.; Paschoal, Ricardo C.; Portes, Dirceu, Jr.; Rodrigues, Hilario

2018-03-01

Sonoluminescence is the phenomenon in which acoustic energy is (partially) transformed into light as a bubble of gas collapses inside a liquid medium. One particular model used to explain the motion of the bubble’s wall forced by acoustic pressure is expressed by the Rayleigh-Plesset equation, which can be obtained from the Navier-Stokes equation. In this article, we describe an alternative approach to derive the Rayleigh-Plesset equation based on Lagrangian mechanics. This work is addressed mainly to undergraduate students and teachers. It requires knowledge of calculus and of many concepts from various fields of physics at the intermediate level.

Navigating the Road to Success: A Systematic Approach to Preparing Competitive Grant Proposals

Directory of Open Access Journals (Sweden)

Theresa Mackenzie

2007-03-01

Full Text Available Purpose Difficulty in securing research funding has been cited as one barrier to the involvement of more librarians and information professionals in conducting original research. This article seeks to support the work of librarians who wish to secure research funding by describing a systematic approach to the creation of successful grant applications.Approach The authors draw on more than fifteen years collective experience in supporting the development of successful research grant proposals. Eleven grant‐writing best practicesor ‘key approaches’ are described, and a planning timeline is suggested.Conclusions: Use of these best practices can assist researchers in creating successful research grant proposals that will also help streamline the research process once it is underway. It is important to recognize the competitive nature of research grant competitions, obtain feedback from an internal review panel, and use feedback from funding agencies to strengthen future grant applications.

Approaches to health-care provider education and professional development in perinatal depression: a systematic review.

Science.gov (United States)

Legere, Laura E; Wallace, Katherine; Bowen, Angela; McQueen, Karen; Montgomery, Phyllis; Evans, Marilyn

2017-07-24

lack of strong research in multi-disciplinary, sector, site, and modal approaches to education and professional development for providers to identify and care for women at risk for, or experiencing, depression. To ensure optimal health outcomes, further research comparing diverse educational and professional development approaches is needed to identify the most effective strategies and consistently meet the needs of health-care providers. A protocol for this systematic review was registered on PROSPERO (Protocol number: CRD42015023701 ), June 21, 2015.

Which alternative communication methods are effective for voiceless patients in Intensive Care Units? A systematic review.

Science.gov (United States)

Carruthers, Helen; Astin, Felicity; Munro, Wendy

2017-10-01

To assess the effectiveness of Augmentative and Alternative Communication (AAC) strategies to enable people who are temporarily voiceless due to medical intervention, to communicate. A systematic review informed by a protocol published on an international register. Ten databases were searched from January 2004 to January 2017. Included studies assessed the effect of using AAC strategies on patient related outcomes and barriers to their use. All included studies were quality appraised. Due to the heterogeneity of interventions and outcome measures findings were narratively reviewed. Twelve studies met the inclusion criteria and were included in the review reporting outcomes from 1981 patient and 454 health professional participants. The quality of included studies were moderate to weak. AAC communication strategies increased the number of communication interactions, improved patient satisfaction with communication and reduced communication difficulties. Barriers to usage were device characteristics, the clinical condition of the patient, lack of timeliness in communication and staff constraints. There is preliminary, but inconsistent evidence that AAC strategies are effective in improving patient satisfaction with communication and reducing difficulties in communication. A lack of comparable studies precluded the identification of the most effective AAC strategy. Copyright © 2017 Elsevier Ltd. All rights reserved.

Complementary, alternative, and other noncomplete decongestive therapy treatment methods in the management of lymphedema: a systematic search and review.

Science.gov (United States)

Rodrick, Julia R; Poage, Ellen; Wanchai, Ausanee; Stewart, Bob R; Cormier, Janice N; Armer, Jane M

2014-03-01

(1) To provide a critical analysis of the contemporary published research that pertains to complementary, alternative, and other noncomplete decongestive therapies for treatment of lymphedema (LE), and (2) to provide practical applications of that evidence to improve care of patients with or at risk for LE. TYPE: This study meets the defining criteria as a systematic search and review because it includes varied study types. All studies that met the inclusion criteria were evaluated for weight of evidence and value. The systematic search and review includes articles published in the contemporary literature (2004-2012). Publications published from 2004-2011 were retrieved from 11 major medical indices by using search terms for LE and management approaches. Literature archives were examined through 2012. Data extraction included study design, objectives pertaining to LE, number and characteristics of participants, interventions, and outcomes. Study strengths and weaknesses were summarized. Study evidence was categorized according to the Oncology Nursing Society Putting Evidence into Practice level-of-evidence guidelines after achieving consensus among the authors. No authors participated in development of nor benefitted from the review of these modality methods or devices. Extracted data from 85 studies were reviewed in 4 subcategories: botanical, pharmaceutical, physical agent modality, and modalities of contemporary value. After review, 47 articles were excluded, which left 16 articles on botanicals and pharmaceuticals and 22 articles for physical agent modality and/or modalities of contemporary value. Pharmaceuticals were later excluded. The authors concluded that botanicals had generated sufficient studies to support a second, more specific systematic review; thus, botanicals are reported elsewhere. It was found that limited high-level evidence was available for all categories. Well-constructed randomized controlled trials related specifically to LE were limited

A Systematic Protein Refolding Screen Method using the DGR Approach Reveals that Time and Secondary TSA are Essential Variables.

Science.gov (United States)

Wang, Yuanze; van Oosterwijk, Niels; Ali, Ameena M; Adawy, Alaa; Anindya, Atsarina L; Dömling, Alexander S S; Groves, Matthew R

2017-08-24

Refolding of proteins derived from inclusion bodies is very promising as it can provide a reliable source of target proteins of high purity. However, inclusion body-based protein production is often limited by the lack of techniques for the detection of correctly refolded protein. Thus, the selection of the refolding conditions is mostly achieved using trial and error approaches and is thus a time-consuming process. In this study, we use the latest developments in the differential scanning fluorimetry guided refolding approach as an analytical method to detect correctly refolded protein. We describe a systematic buffer screen that contains a 96-well primary pH-refolding screen in conjunction with a secondary additive screen. Our research demonstrates that this approach could be applied for determining refolding conditions for several proteins. In addition, it revealed which "helper" molecules, such as arginine and additives are essential. Four different proteins: HA-RBD, MDM2, IL-17A and PD-L1 were used to validate our refolding approach. Our systematic protocol evaluates the impact of the "helper" molecules, the pH, buffer system and time on the protein refolding process in a high-throughput fashion. Finally, we demonstrate that refolding time and a secondary thermal shift assay buffer screen are critical factors for improving refolding efficiency.

Assessing the use of magnetic resonance imaging virtopsy as an alternative to autopsy: a systematic review and meta-analysis.

Science.gov (United States)

Ahmad, Mohammad Usman; Sharif, Kamal Ali; Qayyum, Haisum; Ehsanullah, Bushra; Balyasnikova, Svetlana; Wale, Anita; Shanmuganandan, Arun; Siddiqui, Muhammed Rafay Sameem; Athanasiou, Thanos; Kemp, Graham John

2017-11-01

The post mortem examination or autopsy is a trusted method of identifying the cause of death. Patients and their families may oppose an autopsy for a variety of reasons, including fear of mutilation or owing to religious and personal beliefs. Imaging alternatives to autopsy have been explored, which may provide a viable alternative. To explore the possibility of using MRI virtopsy to establish the cause of death as an alternative to the traditional post mortem examination or autopsy. Systematic review was carried out of all studies, without language restriction, identified from Medline, Cochrane (1960-2016) and Embase (1991-2016) up to December 2016. Further searches were performed using the bibliographies of articles and abstracts. All studies reporting the diagnosis of the cause of death by both MRI virtopsy and traditional autopsy were included. Five studies with 107 patients, contributed to a summative quantitative outcome in adults. The combined sensitivity of MRI virtopsy was 0.82 (95% CI 0.56 to 0.94) with a diagnostic odds ratio (DOR) of 11.1 (95% CI 2.2 to 57.0). There was no significant heterogeneity between studies (Q=1.96, df=4, p=0.75, I 2 =0). Eight studies, with 953 patients contributed to a summative quantitative outcome in children. The combined sensitivity of MRI virtopsy was 0.73 (95% CI 0.59 to 0.84) with a DOR of 6.44 (95% CI 1.36 to 30.51). There was significant heterogeneity between studies (Q=34.95, df=7, pautopsy. By using MRI virtopsy, a potential cost reduction of at least 33% is feasible, and therefore ought to be considered in eligible patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Seismic safety margins research program. Phase I. Project VII: systems analysis specifications of computational approach

International Nuclear Information System (INIS)

Collins, J.D.; Hudson, J.M.; Chrostowski, J.D.

1979-02-01

A computational methodology is presented for the prediction of core melt probabilities in a nuclear power plant due to earthquake events. The proposed model has four modules: seismic hazard, structural dynamic (including soil-structure interaction), component failure and core melt sequence. The proposed modules would operate in series and would not have to be operated at the same time. The basic statistical approach uses a Monte Carlo simulation to treat random and systematic error but alternate statistical approaches are permitted by the program design

Implementation of systematic training approach in Kozloduy Training Centre - Current situation. Presentation of Bulgaria

International Nuclear Information System (INIS)

Kosturkov, L.

1993-01-01

To identify the needs in implementation of the systematic training approach, a relation between the number of trainees, duration of the training and the type of training should be made. In other hand, as it was stated in the TWG-T(93) Status Report, in order to be better identified outstanding training needs, the existing capabilities and other related projects should be taken into account. This report is pointed to give more details for the current situation in Bulgaria and to clarify the needs of international assistance. 3 refs, 3 tabs

Towards electromechanical computation: An alternative approach to realize complex logic circuits

KAUST Repository

Hafiz, Md Abdullah Al; Kosuru, Lakshmoji; Younis, Mohammad I.

2016-01-01

Electromechanical computing based on micro/nano resonators has recently attracted significant attention. However, full implementation of this technology has been hindered by the difficulty in realizing complex logic circuits. We report here an alternative approach to realize complex logic circuits based on multiple MEMS resonators. As case studies, we report the construction of a single-bit binary comparator, a single-bit 4-to-2 encoder, and parallel XOR/XNOR and AND/NOT logic gates. Toward this, several microresonators are electrically connected and their resonance frequencies are tuned through an electrothermal modulation scheme. The microresonators operating in the linear regime do not require large excitation forces, and work at room temperature and at modest air pressure. This study demonstrates that by reconfiguring the same basic building block, tunable resonator, several essential complex logic functions can be achieved.

Towards electromechanical computation: An alternative approach to realize complex logic circuits

KAUST Repository

Hafiz, M. A. A.

2016-08-18

Electromechanical computing based on micro/nano resonators has recently attracted significant attention. However, full implementation of this technology has been hindered by the difficulty in realizing complex logic circuits. We report here an alternative approach to realize complex logic circuits based on multiple MEMS resonators. As case studies, we report the construction of a single-bit binary comparator, a single-bit 4-to-2 encoder, and parallel XOR/XNOR and AND/NOT logic gates. Toward this, several microresonators are electrically connected and their resonance frequencies are tuned through an electrothermal modulation scheme. The microresonators operating in the linear regime do not require large excitation forces, and work at room temperature and at modest air pressure. This study demonstrates that by reconfiguring the same basic building block, tunable resonator, several essential complex logic functions can be achieved.

An alternative approach for modeling strength differential effect in sheet metals with symmetric yield functions

Science.gov (United States)

Kurukuri, Srihari; Worswick, Michael J.

2013-12-01

An alternative approach is proposed to utilize symmetric yield functions for modeling the tension-compression asymmetry commonly observed in hcp materials. In this work, the strength differential (SD) effect is modeled by choosing separate symmetric plane stress yield functions (for example, Barlat Yld 2000-2d) for the tension i.e., in the first quadrant of principal stress space, and compression i.e., third quadrant of principal stress space. In the second and fourth quadrants, the yield locus is constructed by adopting interpolating functions between uniaxial tensile and compressive stress states. In this work, different interpolating functions are chosen and the predictive capability of each approach is discussed. The main advantage of this proposed approach is that the yield locus parameters are deterministic and relatively easy to identify when compared to the Cazacu family of yield functions commonly used for modeling SD effect observed in hcp materials.

Systematic reviews of adverse effects: framework for a structured approach

Directory of Open Access Journals (Sweden)

Herxheimer Andrew

2007-07-01

Full Text Available Abstract Background As every healthcare intervention carries some risk of harm, clinical decision making needs to be supported by a systematic assessment of the balance of benefit to harm. A systematic review that considers only the favourable outcomes of an intervention, without also assessing the adverse effects, can mislead by introducing a bias favouring the intervention. Much of the current guidance on systematic reviews is directed towards the evaluation of effectiveness; but this differs in important ways from the methods used in assessing the safety and tolerability of an intervention. A detailed discussion of why, how and when to include adverse effects in a systematic review, is required. Methods This discussion paper, which presupposes a basic knowledge of systematic review methodology, was developed by consensus among experienced reviewers, members of the Adverse Effects Subgroup of The Cochrane Collaboration, and supplemented by a consultation of content experts in reviews methodology, as well as those working in drug safety. Results A logical framework for making decisions in reviews that incorporate adverse effects is provided. We explore situations where a comprehensive investigation of adverse effects is warranted and suggest strategies to identify practicable and clinically useful outcomes. The advantages and disadvantages of including observational and experimental study designs are reviewed. The consequences of including separate studies for intended and unintended effects are explained. Detailed advice is given on designing electronic searches for studies with adverse effects data. Reviewers of adverse effects are given general guidance on the assessment of study bias, data collection, analysis, presentation and the interpretation of harms in a systematic review. Conclusion Readers need to be able to recognize how strategic choices made in the review process determine what harms are found, and how the findings may affect

Genome-wide dynamics of alternative polyadenylation in rice

Science.gov (United States)

Fu, Haihui; Yang, Dewei; Su, Wenyue; Ma, Liuyin; Shen, Yingjia; Ji, Guoli; Ye, Xinfu; Wu, Xiaohui

2016-01-01

Alternative polyadenylation (APA), in which a transcript uses one of the poly(A) sites to define its 3′-end, is a common regulatory mechanism in eukaryotic gene expression. However, the potential of APA in determining crop agronomic traits remains elusive. This study systematically tallied poly(A) sites of 14 different rice tissues and developmental stages using the poly(A) tag sequencing (PAT-seq) approach. The results indicate significant involvement of APA in developmental and quantitative trait loci (QTL) gene expression. About 48% of all expressed genes use APA to generate transcriptomic and proteomic diversity. Some genes switch APA sites, allowing differentially expressed genes to use alternate 3′ UTRs. Interestingly, APA in mature pollen is distinct where differential expression levels of a set of poly(A) factors and different distributions of APA sites are found, indicating a unique mRNA 3′-end formation regulation during gametophyte development. Equally interesting, statistical analyses showed that QTL tends to use APA for regulation of gene expression of many agronomic traits, suggesting a potential important role of APA in rice production. These results provide thus far the most comprehensive and high-resolution resource for advanced analysis of APA in crops and shed light on how APA is associated with trait formation in eukaryotes. PMID:27733415

Alternative approaches to community participation beyond formal structures: evidence from Langa within the municipality of Cape Town

Directory of Open Access Journals (Sweden)

Adam Andani

2018-05-01

Full Text Available While ward committees and Integrated Development Planning (IDP representative forums constitute formal participatory mechanisms in South Africa’s local government, little is known about the potential of local approaches in enhancing participation in municipal planning. This paper examines alternative approaches to participation based on research conducted in Langa – a township situated on the Cape Flats of Cape Town. The paper highlights approaches to residents’ participation in planning tested during the ‘interregnum’ – the period when ward committees are in abeyance due to elections. The study found that, while IDP participatory processes facilitated awareness of participation, ward councillors were crucial in operationalising participation that reflects the diversity of the community.

In Vivo Desensitization: An Alternative to Systematic Desensitization with College Students

Science.gov (United States)

Atkinson, Donald R.

1973-01-01

It is the thesis of this article that college counselors would make more economical and efficacious use of their time and would greatly reduce the risk of turning off'' students if they employed in vivo desensitization rather than systematic desensitization when dealing with anxious clients. (Author)

Evaluation Policy Alternatives for the Reengineering of the Department of Defense Personal Property Shipment and Storage Program - A Stakeholder Approach

National Research Council Canada - National Science Library

Lepson, Michael

1999-01-01

...) to evaluate the personal property pilot programs as part of Management Reform Memorandum # 6. This thesis evaluates the policy alternatives for reengineering the DOD personal property program using a stakeholder approach...

Scientific Evaluation and Review of Claims in Health Care (SEaRCH): A Streamlined, Systematic, Phased Approach for Determining "What Works" in Healthcare.

Science.gov (United States)

Jonas, Wayne B; Crawford, Cindy; Hilton, Lara; Elfenbaum, Pamela

2017-01-01

Answering the question of "what works" in healthcare can be complex and requires the careful design and sequential application of systematic methodologies. Over the last decade, the Samueli Institute has, along with multiple partners, developed a streamlined, systematic, phased approach to this process called the Scientific Evaluation and Review of Claims in Health Care (SEaRCH™). The SEaRCH process provides an approach for rigorously, efficiently, and transparently making evidence-based decisions about healthcare claims in research and practice with minimal bias. SEaRCH uses three methods combined in a coordinated fashion to help determine what works in healthcare. The first, the Claims Assessment Profile (CAP), seeks to clarify the healthcare claim and question, and its ability to be evaluated in the context of its delivery. The second method, the Rapid Evidence Assessment of the Literature (REAL © ), is a streamlined, systematic review process conducted to determine the quantity, quality, and strength of evidence and risk/benefit for the treatment. The third method involves the structured use of expert panels (EPs). There are several types of EPs, depending on the purpose and need. Together, these three methods-CAP, REAL, and EP-can be integrated into a strategic approach to help answer the question "what works in healthcare?" and what it means in a comprehensive way. SEaRCH is a systematic, rigorous approach for evaluating healthcare claims of therapies, practices, programs, or products in an efficient and stepwise fashion. It provides an iterative, protocol-driven process that is customized to the intervention, consumer, and context. Multiple communities, including those involved in health service and policy, can benefit from this organized framework, assuring that evidence-based principles determine which healthcare practices with the greatest promise are used for improving the public's health and wellness.

Producing Cochrane systematic reviews-a qualitative study of current approaches and opportunities for innovation and improvement.

Science.gov (United States)

Turner, Tari; Green, Sally; Tovey, David; McDonald, Steve; Soares-Weiser, Karla; Pestridge, Charlotte; Elliott, Julian

2017-08-01

Producing high-quality, relevant systematic reviews and keeping them up to date is challenging. Cochrane is a leading provider of systematic reviews in health. For Cochrane to continue to contribute to improvements in heath, Cochrane Reviews must be rigorous, reliable and up to date. We aimed to explore existing models of Cochrane Review production and emerging opportunities to improve the efficiency and sustainability of these processes. To inform discussions about how to best achieve this, we conducted 26 interviews and an online survey with 106 respondents. Respondents highlighted the importance and challenge of creating reliable, timely systematic reviews. They described the challenges and opportunities presented by current production models, and they shared what they are doing to improve review production. They particularly highlighted significant challenges with increasing complexity of review methods; difficulty keeping authors on board and on track; and the length of time required to complete the process. Strong themes emerged about the roles of authors and Review Groups, the central actors in the review production process. The results suggest that improvements to Cochrane's systematic review production models could come from improving clarity of roles and expectations, ensuring continuity and consistency of input, enabling active management of the review process, centralising some review production steps; breaking reviews into smaller "chunks", and improving approaches to building capacity of and sharing information between authors and Review Groups. Respondents noted the important role new technologies have to play in enabling these improvements. The findings of this study will inform the development of new Cochrane Review production models and may provide valuable data for other systematic review producers as they consider how best to produce rigorous, reliable, up-to-date reviews.

Parametric Optimization of Some Critical Operating System Functions--An Alternative Approach to the Study of Operating Systems Design

Science.gov (United States)

Sobh, Tarek M.; Tibrewal, Abhilasha

2006-01-01

Operating systems theory primarily concentrates on the optimal use of computing resources. This paper presents an alternative approach to teaching and studying operating systems design and concepts by way of parametrically optimizing critical operating system functions. Detailed examples of two critical operating systems functions using the…

Cat dissection and human cadaver prosection versus sculpting human structures from clay: A comparison of alternate approaches to human anatomy laboratory education

Science.gov (United States)

Waters, John R.

Dissection and vivisection are traditional approaches to biology laboratory education. In the case of human anatomy teaching laboratories, there is a long tradition of using human and animal cadaver specimens in the classroom. In a review of the literature comparing traditional dissection and vivisection lessons to alternative lessons designed to reduce the time spent dissecting or the numbers of animals used, we conclude that it is difficult to come to any conclusion regarding the efficacy of different approaches. An analysis of the literature is confounded because many studies have very low statistical power or other methodological weaknesses, and investigators rely on a wide variety of testing instruments to measure an equally varied number of course objectives. Additional well designed studies are necessary before educators can reach any informed conclusions about the efficacy of traditional versus alternative approaches to laboratory education. In our experiments, we compared a traditional cat dissection based undergraduate human anatomy lesson to an alternative where students sculpted human muscles onto plastic human skeletons. Students in the alternative treatment performed significantly better than their peers in the traditional treatment when answering both lower and higher order human anatomy questions. In a subsequent experiment with a similar design, we concluded that the superior performance of the students in the alternative treatment on anatomy exams was likely due to the similarity between the human anatomy representation studied in lab, and the human anatomy questions asked on the exams. When the anatomy questions were presented in the context of a cat specimen, students in the traditional cat dissection treatment outperformed their peers in the alternative treatment. In a final experiment where student performance on a human anatomy exam was compared between a traditional prosected human cadaver treatment and the alternative clay sculpting

The Functional Impact of Alternative Splicing in Cancer.

Science.gov (United States)

Climente-González, Héctor; Porta-Pardo, Eduard; Godzik, Adam; Eyras, Eduardo

2017-08-29

Alternative splicing changes are frequently observed in cancer and are starting to be recognized as important signatures for tumor progression and therapy. However, their functional impact and relevance to tumorigenesis remain mostly unknown. We carried out a systematic analysis to characterize the potential functional consequences of alternative splicing changes in thousands of tumor samples. This analysis revealed that a subset of alternative splicing changes affect protein domain families that are frequently mutated in tumors and potentially disrupt protein-protein interactions in cancer-related pathways. Moreover, there was a negative correlation between the number of these alternative splicing changes in a sample and the number of somatic mutations in drivers. We propose that a subset of the alternative splicing changes observed in tumors may represent independent oncogenic processes that could be relevant to explain the functional transformations in cancer, and some of them could potentially be considered alternative splicing drivers (AS drivers). Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

The Emergence of Systematic Review in Toxicology.

Science.gov (United States)

Stephens, Martin L; Betts, Kellyn; Beck, Nancy B; Cogliano, Vincent; Dickersin, Kay; Fitzpatrick, Suzanne; Freeman, James; Gray, George; Hartung, Thomas; McPartland, Jennifer; Rooney, Andrew A; Scherer, Roberta W; Verloo, Didier; Hoffmann, Sebastian

2016-07-01

The Evidence-based Toxicology Collaboration hosted a workshop on "The Emergence of Systematic Review and Related Evidence-based Approaches in Toxicology," on November 21, 2014 in Baltimore, Maryland. The workshop featured speakers from agencies and organizations applying systematic review approaches to questions in toxicology, speakers with experience in conducting systematic reviews in medicine and healthcare, and stakeholders in industry, government, academia, and non-governmental organizations. Based on the workshop presentations and discussion, here we address the state of systematic review methods in toxicology, historical antecedents in both medicine and toxicology, challenges to the translation of systematic review from medicine to toxicology, and thoughts on the way forward. We conclude with a recommendation that as various agencies and organizations adapt systematic review methods, they continue to work together to ensure that there is a harmonized process for how the basic elements of systematic review methods are applied in toxicology. © The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology.

A Systematic Approach to Identify Sources of Abnormal Interior Noise for a High-Speed Train

Directory of Open Access Journals (Sweden)

Jie Zhang

2018-01-01

Full Text Available A systematic approach to identify sources of abnormal interior noise occurring in a high-speed train is presented and applied in this paper to resolve a particular noise issue. This approach is developed based on a number of previous dealings with similar noise problems. The particular noise issue occurs in a Chinese high-speed train. It is measured that there is a difference of 7 dB(A in overall Sound Pressure Level (SPL between two nominally identical VIP cabins at 250 km/h. The systematic approach is applied to identify the root cause of the 7 dB(A difference. Well planned measurements are performed in both the VIP cabins. Sound pressure contributions, either in terms of frequency band or in terms of facing area, are analyzed. Order analysis is also carried out. Based on these analyses, it is found that the problematic frequency is the sleeper passing frequency of the train, and an area on the roof contributes the most. In order to determine what causes that area to be the main contributor without disassembling the structure of the roof, measured noise and vibration data for different train speeds are further analyzed. It is then reasoned that roof is the main contributor caused by sound pressure behind the panel. Up to this point, panels of the roof are removed, revealing that a hole of 300 cm2 for running cables is presented behind the red area without proper sound insulation. This study can provide a basis for abnormal interior noise analysis and control of high-speed trains.

Pharmacokinetics of Alternative Administration Routes of Melatonin

DEFF Research Database (Denmark)

Zetner, D.; Andersen, L. P.H.; Rosenberg, J.

2016-01-01

Background: Melatonin is traditionally administered orally but has a poor and variable bioavailability. This study aims to present an overview of studies investigating the pharmacokinetics of alternative administration routes of melatonin. Methods: A systematic literature search was performed...... and included experimental or clinical studies, investigating pharmacokinetics of alternative administration routes of melatonin in vivo. Alternative administration routes were defined as all administration routes except oral and intravenous. Results: 10 studies were included in the review. Intranasal....... Subcutaneous injection of melatonin displayed a rapid absorption rate compared to oral administration. Conclusion: Intranasal administration of melatonin has a large potential, and more research in humans is warranted. Transdermal application of melatonin has a possible use in a local application, due to slow...

Systematic Desensitization as Training in Self-Control

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Goldfried, Marvin R.

1971-01-01

A description of a mediational model to explain the effectiveness of desensitization and a discussion of the available corroborative research findings for this alternative explanation are given. Also, specific procedural modifications for systematic desensitization are suggested. (Author)

A systematic review and meta-analysis of online versus alternative methods for training licensed health care professionals to deliver clinical interventions

Directory of Open Access Journals (Sweden)

Helen Richmond

2017-11-01

Full Text Available Abstract Background Online training is growing in popularity and yet its effectiveness for training licensed health professionals (HCPs in clinical interventions is not clear. We aimed to systematically review the literature on the effectiveness of online versus alternative training methods in clinical interventions for licensed Health Care Professionals (HCPs on outcomes of knowledge acquisition, practical skills, clinical behaviour, self-efficacy and satisfaction. Methods Seven databases were searched for randomised controlled trials (RCTs from January 2000 to June 2015. Two independent reviewers rated trial quality and extracted trial data. Comparative effects were summarised as standardised mean differences (SMD and 95% confidence intervals. Pooled effect sizes were calculated using a random-effects model for three contrasts of online versus (i interactive workshops (ii taught lectures and (iii written/electronic manuals. Results We included 14 studies with a total of 1089 participants. Most trials studied medical professionals, used a workshop or lecture comparison, were of high risk of bias and had small sample sizes (range 21-183. Using the GRADE approach, we found low quality evidence that there was no difference between online training and an interactive workshop for clinical behaviour SMD 0.12 (95% CI -0.13 to 0.37. We found very low quality evidence of no difference between online methods and both a workshop and lecture for knowledge (workshop: SMD 0.04 (95% CI -0.28 to 0.36; lecture: SMD 0.22 (95% CI: -0.08, 0.51. Lastly, compared to a manual (n = 3/14, we found very low quality evidence that online methods were superior for knowledge SMD 0.99 (95% CI 0.02 to 1.96. There were too few studies to draw any conclusions on the effects of online training for practical skills, self-efficacy, and satisfaction across all contrasts. Conclusions It is likely that online methods may be as effective as alternative methods for training HCPs in

A systematic review and meta-analysis of online versus alternative methods for training licensed health care professionals to deliver clinical interventions.

Science.gov (United States)

Richmond, Helen; Copsey, Bethan; Hall, Amanda M; Davies, David; Lamb, Sarah E

2017-11-23

Online training is growing in popularity and yet its effectiveness for training licensed health professionals (HCPs) in clinical interventions is not clear. We aimed to systematically review the literature on the effectiveness of online versus alternative training methods in clinical interventions for licensed Health Care Professionals (HCPs) on outcomes of knowledge acquisition, practical skills, clinical behaviour, self-efficacy and satisfaction. Seven databases were searched for randomised controlled trials (RCTs) from January 2000 to June 2015. Two independent reviewers rated trial quality and extracted trial data. Comparative effects were summarised as standardised mean differences (SMD) and 95% confidence intervals. Pooled effect sizes were calculated using a random-effects model for three contrasts of online versus (i) interactive workshops (ii) taught lectures and (iii) written/electronic manuals. We included 14 studies with a total of 1089 participants. Most trials studied medical professionals, used a workshop or lecture comparison, were of high risk of bias and had small sample sizes (range 21-183). Using the GRADE approach, we found low quality evidence that there was no difference between online training and an interactive workshop for clinical behaviour SMD 0.12 (95% CI -0.13 to 0.37). We found very low quality evidence of no difference between online methods and both a workshop and lecture for knowledge (workshop: SMD 0.04 (95% CI -0.28 to 0.36); lecture: SMD 0.22 (95% CI: -0.08, 0.51)). Lastly, compared to a manual (n = 3/14), we found very low quality evidence that online methods were superior for knowledge SMD 0.99 (95% CI 0.02 to 1.96). There were too few studies to draw any conclusions on the effects of online training for practical skills, self-efficacy, and satisfaction across all contrasts. It is likely that online methods may be as effective as alternative methods for training HCPs in clinical interventions for the outcomes of knowledge

Teaching Areas of Polygons: An Alternative Approach

Science.gov (United States)

Hoosain, Emam

2010-01-01

Measurement is an integral component of the PK-12 mathematics curriculum. At various grade levels, much attention is given to the areas of geometric shapes. However, there is research evidence that measurement is problematic for US students. In this paper, the merits and demerits of two possible sequences (conventional and alternative) in teaching…

A tiered approach to the use of alternatives to animal testing for the safety assessment of cosmetics: eye irritation.

Science.gov (United States)

McNamee, Pauline; Hibatallah, Jalila; Costabel-Farkas, Margit; Goebel, Carsten; Araki, Daisuke; Dufour, Eric; Hewitt, Nicola J; Jones, Penny; Kirst, Annette; Le Varlet, Béatrice; Macfarlane, Martin; Marrec-Fairley, Monique; Rowland, Joanna; Schellauf, Florian; Scheel, Julia

2009-07-01

The need for alternative approaches to replace the in vivo rabbit Draize eye test for evaluation of eye irritation of cosmetic ingredients has been recognised by the cosmetics industry for many years. Extensive research has lead to the development of several assays, some of which have undergone formal validation. Even though, to date, no single in vitro assay has been validated as a full replacement for the rabbit Draize eye test, organotypic assays are accepted for specific and limited regulatory purposes. Although not formally validated, several other in vitro models have been used for over a decade by the cosmetics industry as valuable tools in a weight of evidence approach for the safety assessment of ingredients and finished products. In light of the deadlines established in the EU Cosmetics Directive for cessation of animal testing for cosmetic ingredients, a COLIPA scientific meeting was held in Brussels on 30th January, 2008 to review the use of alternative approaches and to set up a decision-tree approach for their integration into tiered testing strategies for hazard and safety assessment of cosmetic ingredients and their use in products. Furthermore, recommendations are given on how remaining data gaps and research needs can be addressed.

Performance of alternative strategies for primary cervical cancer screening in sub-Saharan Africa: systematic review and meta-analysis of diagnostic test accuracy studies

Science.gov (United States)

Combescure, Christophe; Fokom-Defo, Victoire; Tebeu, Pierre Marie; Vassilakos, Pierre; Kengne, André Pascal; Petignat, Patrick

2015-01-01

Objective To assess and compare the accuracy of visual inspection with acetic acid (VIA), visual inspection with Lugol’s iodine (VILI), and human papillomavirus (HPV) testing as alternative standalone methods for primary cervical cancer screening in sub-Saharan Africa. Design Systematic review and meta-analysis of diagnostic test accuracy studies. Data sources Systematic searches of multiple databases including Medline, Embase, and Scopus for studies published between January 1994 and June 2014. Review methods Inclusion criteria for studies were: alternative methods to cytology used as a standalone test for primary screening; study population not at particular risk of cervical cancer (excluding studies focusing on HIV positive women or women with gynaecological symptoms); women screened by nurses; reference test (colposcopy and directed biopsies) performed at least in women with positive screening results. Two reviewers independently screened studies for eligibility and extracted data for inclusion, and evaluated study quality using the quality assessment of diagnostic accuracy studies 2 (QUADAS-2) checklist. Primary outcomes were absolute accuracy measures (sensitivity and specificity) of screening tests to detect cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Results 15 studies of moderate quality were included (n=61 381 for VIA, n=46 435 for VILI, n=11 322 for HPV testing). Prevalence of CIN2+ did not vary by screening test and ranged from 2.3% (95% confidence interval 1.5% to 3.3%) in VILI studies to 4.9% (2.7% to 7.8%) in HPV testing studies. Positivity rates of VILI, VIA, and HPV testing were 16.5% (9.8% to 24.7%), 16.8% (11.0% to 23.6%), and 25.8% (17.4% to 35.3%), respectively. Pooled sensitivity was higher for VILI (95.1%; 90.1% to 97.7%) than VIA (82.4%; 76.3% to 87.3%) in studies where the reference test was performed in all women (Psub-Saharan Africa, VILI is a simple and affordable alternative to cytology that demonstrates higher

"Ultra-rapid" sequential treatment in cholecystocholedocholithiasis: alternative same-day approach to laparoendoscopic rendezvous.

Science.gov (United States)

Borreca, Dario; Bona, Alberto; Bellomo, Maria Paola; Borasi, Andrea; De Paolis, Paolo

2015-12-01

There is still no consensus about timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography in the treatment of cholecystocholedocholithiasis. The aim of our retrospective study is to analyze the optimal timing of surgical treatment in patients presenting concurrent choledocholithiasis, choosing to perform a sequential endoscopic plus surgical approach, introducing a same-day two-stage alternative. All cases of cholecystocholedocholithiasis occurred between January 2007 and December 2014 in "Gradenigo" Hospital (Turin-Italy) were reviewed. Patients were divided into three groups, based on the timing of cholecystectomy after endoscopic retrograde cholangiopancreatography, and compared. Out of 2233 cholecystectomies performed in the mentioned time interval, have been identified 93 patients that fulfill the selection criteria. 36 patients were treated with a same-day approach, while 29 within first 72 h and 28 with delayed surgery. The overall length of stay was significantly lower in patients that were treated with a same-day approach (4.7 days), compared with other groups (p = 0.001), while no significant differences were found in terms of length of surgical intervention, intraoperative complications and conversions to open procedure, postoperative stay, morbidity and mortality. Patients treated with delayed surgery had a 18 % recurrency rate of biliary events, with an odds ratio of 14.13 (p = 0.018). Same-day two-stage approach should be performed in suitable patients at the index admission, reducing overall risks, improving the patients' quality-of-life, preventing recurrency, leading to a significant cost abatement; furthermore, this approach allows same outcomes of laparoendoscopic rendezvous, avoiding technical and organizational troubles.

A systematic approach to assessing the clinical significance of genetic variants.

Science.gov (United States)

Duzkale, H; Shen, J; McLaughlin, H; Alfares, A; Kelly, M A; Pugh, T J; Funke, B H; Rehm, H L; Lebo, M S

2013-11-01

Molecular genetic testing informs diagnosis, prognosis, and risk assessment for patients and their family members. Recent advances in low-cost, high-throughput DNA sequencing and computing technologies have enabled the rapid expansion of genetic test content, resulting in dramatically increased numbers of DNA variants identified per test. To address this challenge, our laboratory has developed a systematic approach to thorough and efficient assessments of variants for pathogenicity determination. We first search for existing data in publications and databases including internal, collaborative and public resources. We then perform full evidence-based assessments through statistical analyses of observations in the general population and disease cohorts, evaluation of experimental data from in vivo or in vitro studies, and computational predictions of potential impacts of each variant. Finally, we weigh all evidence to reach an overall conclusion on the potential for each variant to be disease causing. In this report, we highlight the principles of variant assessment, address the caveats and pitfalls, and provide examples to illustrate the process. By sharing our experience and providing a framework for variant assessment, including access to a freely available customizable tool, we hope to help move towards standardized and consistent approaches to variant assessment. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

An Electrostatics Approach to the Determination of Extremal Measures

Energy Technology Data Exchange (ETDEWEB)

Meinguet, Jean [Universite Catholique de Louvain, Institut Mathematique, Chemin du Cyclotron 2 (Belgium)], E-mail: meinguet@anma.ucl.ac.be

2000-12-15

One of the most important aspects of the minimal energy (or induced equilibrium) problem in the presence of an external field - sometimes referred to as the Gauss variation problem - is the determination of the support of its solution (the so-called extremal measure associated with the field). A simple electrostatic interpretation is presented here, which is apparently new and anyway suggests a novel, rather systematic approach to the solution. By way of illustration, the classical results for Jacobi, Laguerre and Freud weights are explicitly recovered by this alternative method.

An Electrostatics Approach to the Determination of Extremal Measures

International Nuclear Information System (INIS)

Meinguet, Jean

2000-01-01

One of the most important aspects of the minimal energy (or induced equilibrium) problem in the presence of an external field - sometimes referred to as the Gauss variation problem - is the determination of the support of its solution (the so-called extremal measure associated with the field). A simple electrostatic interpretation is presented here, which is apparently new and anyway suggests a novel, rather systematic approach to the solution. By way of illustration, the classical results for Jacobi, Laguerre and Freud weights are explicitly recovered by this alternative method

Complementary and Alternative Medicine Approaches for Pediatric Pain: A Review of the State-of-the-science

OpenAIRE

Tsao, Jennie C. I.; Zeltzer, Lonnie K.

2005-01-01

In recent years, the use of complementary and alternative medicine (CAM) in pediatric populations has increased considerably, especially for chronic conditions such as cancer, rheumatoid arthritis and cystic fibrosis in which pain may be a significant problem. Despite the growing popularity of CAM approaches for pediatric pain, questions regarding the efficacy of these interventions remain. This review critically evaluates the existing empirical evidence for the efficacy of CAM intervention...

Interweaving Teaching and Emotional Support for Novice Special Educators in Alternative Certification Programs

Science.gov (United States)

Ricci, Leila Ansari; Zetlin, Andrea G.

2013-01-01

As the shortage of special education teachers has led to increasing numbers of teacher candidates enrolled in alternative certification programs, there is a need to provide systematic mentoring and coaching. The relationship between support providers and novice teachers enrolled in an alternative certification program in a diverse, urban…

Non-homologous isofunctional enzymes: a systematic analysis of alternative solutions in enzyme evolution.

Science.gov (United States)

Omelchenko, Marina V; Galperin, Michael Y; Wolf, Yuri I; Koonin, Eugene V

2010-04-30

Evolutionarily unrelated proteins that catalyze the same biochemical reactions are often referred to as analogous - as opposed to homologous - enzymes. The existence of numerous alternative, non-homologous enzyme isoforms presents an interesting evolutionary problem; it also complicates genome-based reconstruction of the metabolic pathways in a variety of organisms. In 1998, a systematic search for analogous enzymes resulted in the identification of 105 Enzyme Commission (EC) numbers that included two or more proteins without detectable sequence similarity to each other, including 34 EC nodes where proteins were known (or predicted) to have distinct structural folds, indicating independent evolutionary origins. In the past 12 years, many putative non-homologous isofunctional enzymes were identified in newly sequenced genomes. In addition, efforts in structural genomics resulted in a vastly improved structural coverage of proteomes, providing for definitive assessment of (non)homologous relationships between proteins. We report the results of a comprehensive search for non-homologous isofunctional enzymes (NISE) that yielded 185 EC nodes with two or more experimentally characterized - or predicted - structurally unrelated proteins. Of these NISE sets, only 74 were from the original 1998 list. Structural assignments of the NISE show over-representation of proteins with the TIM barrel fold and the nucleotide-binding Rossmann fold. From the functional perspective, the set of NISE is enriched in hydrolases, particularly carbohydrate hydrolases, and in enzymes involved in defense against oxidative stress. These results indicate that at least some of the non-homologous isofunctional enzymes were recruited relatively recently from enzyme families that are active against related substrates and are sufficiently flexible to accommodate changes in substrate specificity.

Systematic overview finds variation in approaches to investigating and reporting on sources of heterogeneity in systematic reviews of diagnostic studies

NARCIS (Netherlands)

Naaktgeboren, Christiana A.; van Enst, Wynanda A.; Ochodo, Eleanor A.; de Groot, Joris A. H.; Hooft, Lotty; Leeflang, Mariska M.; Bossuyt, Patrick M.; Moons, Karel G. M.; Reitsma, Johannes B.

2014-01-01

To examine how authors explore and report on sources of heterogeneity in systematic reviews of diagnostic accuracy studies. A cohort of systematic reviews of diagnostic tests was systematically identified. Data were extracted on whether an exploration of the sources of heterogeneity was undertaken,

Is magnetic resonance imaging a viable alternative to ultrasound as the primary imaging modality in the diagnosis of paediatric appendicitis? A systematic review

International Nuclear Information System (INIS)

Ogunmefun, G.; Hardy, M.; Boynes, S.

2016-01-01

Background: Appendicitis is the most common cause of acute abdominal pain requiring surgical intervention in paediatric patients. Ultrasound is generally the diagnostic imaging modality of choice, followed by CT, where paediatric appendicitis is suspected. However, high operator dependency and diagnostic restrictions related to anatomical and clinical presentation may limit consistency of application. This paper explores whether MRI is a viable alternative to ultrasound as the primary imaging modality. Method: A systematic review of the literature was undertaken. A search of Medline, Cinahl, PubMed Central and Google Scholar was undertaken supplemented by a review of reference lists, author searching and review of NICE evidence base for existing guidelines. Included studies were assessed for bias using the QUADAS-2 quality assessment tool and data were extracted systematically using a purposefully designed electronic data extraction proforma. Results: Seven studies were included in final review. The age range of participants extended from 0 to 19 years. Only one study with a patient age range of 0–14 used sedation. Sensitivity estimates from the included studies ranged from 92% to 100% while specificity ranged from 89% to 100%. A significant variation in the number and type of sequences was noted between the studies. Conclusion: MRI offers high sensitivity and specificity comparable to contrast enhanced CT and greater than ultrasound as reported in the literature. Where accessibility is not a restriction, MRI is a viable alternative to ultrasound in the assessment and diagnosis of paediatric appendicitis. Clinical practice recommendations have been provided to facilitate the translation of evidence into practice. - Highlights: • MRI may be used as the primary imaging tool to investigate paediatric appendicitis. • Gadolinium is not necessary for MRI evaluation of appendicitis in children. • Sedation for MRI evaluation of appendicitis is not required

The positive deviance/hearth approach to reducing child malnutrition: systematic review.

Science.gov (United States)

Bisits Bullen, Piroska A

2011-11-01

The Positive Deviance/Hearth approach aims to rehabilitate malnourished children using practices from mothers in the community who have well-nourished children despite living in poverty. This study assesses its effectiveness in a range of settings. Systematic review of peer reviewed intervention trials and grey literature evaluation reports of child malnutrition programs using the Positive Deviance/Hearth approach. Ten peer reviewed studies and 14 grey literature reports met the inclusion criteria. These described results for 17 unique Positive Deviance/Hearth programs in 12 countries. Nine programs used a pre- and post-test design without a control, which limited the conclusions that could be drawn. Eight used more robust designs such as non-randomized trials, non-randomized cross-sectional sibling studies and randomized controlled trials (RCTs). Of the eight programs that reported nutritional outcomes, five reported some type of positive result in terms of nutritional status - although the improvement was not always as large as predicted, or across the entire target population. Both the two RCTs demonstrated improvements in carer feeding practices. Qualitative results unanimously reported high levels of satisfaction from participants and recipient communities. Overall this study shows mixed results in terms of program effectiveness, although some Positive Deviance/Hearth programs have clearly been successful in particular settings. Sibling studies suggest that the Positive Deviance/Hearth approach may have a role in preventing malnutrition, not just rehabilitation. Further research is needed using more robust study designs and larger sample sizes. Issues related to community participation and consistency in reporting results need to be addressed. © 2011 Blackwell Publishing Ltd.

Using a systematic approach to select flagship species for bird conservation.

Science.gov (United States)

Veríssimo, Diogo; Pongiluppi, Tatiana; Santos, Maria Cintia M; Develey, Pedro F; Fraser, Iain; Smith, Robert J; MacMilan, Douglas C

2014-02-01

Conservation marketing campaigns that focus on flagship species play a vital role in biological diversity conservation because they raise funds and change people's behavior. However, most flagship species are selected without considering the target audience of the campaign, which can hamper the campaign's effectiveness. To address this problem, we used a systematic and stakeholder-driven approach to select flagship species for a conservation campaign in the Serra do Urubu in northeastern Brazil. We based our techniques on environmental economic and marketing methods. We used choice experiments to examine the species attributes that drive preference and latent-class models to segment respondents into groups by preferences and socioeconomic characteristics. We used respondent preferences and information on bird species inhabiting the Serra do Urubu to calculate a flagship species suitability score. We also asked respondents to indicate their favorite species from a set list to enable comparison between methods. The species' traits that drove audience preference were geographic distribution, population size, visibility, attractiveness, and survival in captivity. However, the importance of these factors differed among groups and groups differed in their views on whether species with small populations and the ability to survive in captivity should be prioritized. The popularity rankings of species differed between approaches, a result that was probably related to the different ways in which the 2 methods measured preference. Our new approach is a transparent and evidence-based method that can be used to refine the way stakeholders are engaged in the design of conservation marketing campaigns. © 2013 Society for Conservation Biology.

Assessing environmental vulnerability in EIA-The content and context of the vulnerability concept in an alternative approach to standard EIA procedure

International Nuclear Information System (INIS)

Kvaerner, Jens; Swensen, Grete; Erikstad, Lars

2006-01-01

In the traditional EIA procedure environmental vulnerability is only considered to a minor extent in the early stages when project alternatives are worked out. In Norway, an alternative approach to EIA, an integrated vulnerability model (IVM), emphasising environmental vulnerability and alternatives development in the early stages of EIA, has been tried out in a few pilot cases. This paper examines the content and use of the vulnerability concept in the IVM approach, and discusses the concept in an EIA context. The vulnerability concept is best suited to overview analyses and large scale spatial considerations. The concept is particularly useful in the early stages of EIA when alternatives are designed and screened. By introducing analyses of environmental vulnerability at the start of the EIA process, the environment can be a more decisive issue for the creation of project alternatives as well as improving the basis for scoping. Vulnerability and value aspects should be considered as separate dimensions. There is a need to operate with a specification between general and specific vulnerability. The concept of environmental vulnerability has proven useful in a wide range of disciplines. Different disciplines have different lengths of experience regarding vulnerability. In disciplines such as landscape planning and hydrogeology we find elements suitable as cornerstones in the further development of an interdisciplinary methodology. Further development of vulnerability criteria in different disciplines and increased public involvement in the early stages of EIA are recommended

Characterization of alternative FBR development strategies

International Nuclear Information System (INIS)

Boegel, A.J.; Clausen, M.J.

1981-08-01

Near-term decisions regarding the nature and place of the FBR development program must be made. This study is part of a larger program designed to provide the Department of Energy (DOE) with imformation that can be used to make strategic programmatic decisions. The focus of this report is the description of alternative approaches for developing the FBR and the quantification of the duration and cost of each alternative. The time frames of the alternative approaches are investigated in companion reports (White 1981 and Fraley 1981). The results of these analyses will be described in a summary report

A tiered approach to the use of alternatives to animal testing for the safety assessment of cosmetics: skin irritation.

Science.gov (United States)

Macfarlane, Martin; Jones, Penny; Goebel, Carsten; Dufour, Eric; Rowland, Joanna; Araki, Daisuke; Costabel-Farkas, Margit; Hewitt, Nicola J; Hibatallah, Jalila; Kirst, Annette; McNamee, Pauline; Schellauf, Florian; Scheel, Julia

2009-07-01

Evaluation of the skin irritancy and corrosivity potential of an ingredient is a necessity in the safety assessment of cosmetic ingredients. To date, there are two formally validated alternatives to the rabbit Draize test for skin corrosivity in place, namely the rat skin transcutaneous electrical resistance (TER) assay and the Human Skin Model Test using EpiSkin, EpiDerm and SkinEthic reconstructed human epidermal equivalents. For skin irritation, EpiSkin, EpiDerm and SkinEthic are validated as stand-alone test replacements for the rabbit Draize test. Data from these tests are rarely considered in isolation and are evaluated in combination with other factors to establish the overall irritating or corrosive potential of an ingredient. In light of the deadlines established in the Cosmetics Directive for cessation of animal testing for cosmetic ingredients, a COLIPA scientific meeting was held in Brussels on 30th January, 2008 to review the use of alternative approaches and to set up a decision tree approach for their integration into tiered testing strategies for hazard and safety assessment of cosmetic ingredients and their use in products. In conclusion, the safety assessments for skin irritation/corrosion of new chemicals for use in cosmetics can be confidently accomplished using exclusively alternative methods.

Identifying approaches for assessing methodological and reporting quality of systematic reviews

DEFF Research Database (Denmark)

Pussegoda, Kusala; Turner, Lucy; Garritty, Chantelle

2017-01-01

there are potential gaps in research best-practice guidance materials. The aims of this study are to identify reports assessing the methodological quality (MQ) and/or reporting quality (RQ) of a cohort of SRs and to assess their number, general characteristics, and approaches to 'quality' assessment over time......BACKGROUND: The methodological quality and completeness of reporting of the systematic reviews (SRs) is fundamental to optimal implementation of evidence-based health care and the reduction of research waste. Methods exist to appraise SRs yet little is known about how they are used in SRs or where...... or reporting guidelines used as proxy to assess RQ were used in 80% (61/76) of identified reports. These included two reporting guidelines (PRISMA and QUOROM) and five quality assessment tools (AMSTAR, R-AMSTAR, OQAQ, Mulrow, Sacks) and GRADE criteria. The remaining 24% (18/76) of reports developed their own...

Performance analysis of air-standard Diesel cycle using an alternative irreversible heat transfer approach

International Nuclear Information System (INIS)

Al-Hinti, I.; Akash, B.; Abu-Nada, E.; Al-Sarkhi, A.

2008-01-01

This study presents the investigation of air-standard Diesel cycle under irreversible heat transfer conditions. The effects of various engine parameters are presented. An alternative approach is used to evaluate net power output and cycle thermal efficiency from more realistic parameters such as air-fuel ratio, fuel mass flow rate, intake temperature, engine design parameters, etc. It is shown that for a given fuel flow rate, thermal efficiency and maximum power output increase with decreasing air-fuel ratio. Also, for a given air-fuel ratio, the maximum power output increases with increasing fuel rate. However, the effect of the thermal efficiency is limited

Scientific Evaluation and Review of Claims in Health Care (SEaRCH): A Streamlined, Systematic, Phased Approach for Determining “What Works” in Healthcare

Science.gov (United States)

Crawford, Cindy; Hilton, Lara; Elfenbaum, Pamela

2017-01-01

Abstract Background: Answering the question of “what works” in healthcare can be complex and requires the careful design and sequential application of systematic methodologies. Over the last decade, the Samueli Institute has, along with multiple partners, developed a streamlined, systematic, phased approach to this process called the Scientific Evaluation and Review of Claims in Health Care (SEaRCH™). The SEaRCH process provides an approach for rigorously, efficiently, and transparently making evidence-based decisions about healthcare claims in research and practice with minimal bias. Methods: SEaRCH uses three methods combined in a coordinated fashion to help determine what works in healthcare. The first, the Claims Assessment Profile (CAP), seeks to clarify the healthcare claim and question, and its ability to be evaluated in the context of its delivery. The second method, the Rapid Evidence Assessment of the Literature (REAL©), is a streamlined, systematic review process conducted to determine the quantity, quality, and strength of evidence and risk/benefit for the treatment. The third method involves the structured use of expert panels (EPs). There are several types of EPs, depending on the purpose and need. Together, these three methods—CAP, REAL, and EP—can be integrated into a strategic approach to help answer the question “what works in healthcare?” and what it means in a comprehensive way. Discussion: SEaRCH is a systematic, rigorous approach for evaluating healthcare claims of therapies, practices, programs, or products in an efficient and stepwise fashion. It provides an iterative, protocol-driven process that is customized to the intervention, consumer, and context. Multiple communities, including those involved in health service and policy, can benefit from this organized framework, assuring that evidence-based principles determine which healthcare practices with the greatest promise are used for improving the public's health and

[Complementary and alternative procedures for fibromyalgia syndrome : Updated guidelines 2017 and overview of systematic review articles].

Science.gov (United States)

Langhorst, J; Heldmann, P; Henningsen, P; Kopke, K; Krumbein, L; Lucius, H; Winkelmann, A; Wolf, B; Häuser, W

2017-06-01

The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A search of the literature for systematic reviews of randomized controlled trials of complementary and alternative therapies from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was formed by multiple step formalized procedures to reach a consensus. Efficacy, risks, patient preferences and applicability of available therapies were weighed up against each other. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. Meditative movement therapies (e.g. qi gong, tai chi and yoga) are strongly recommended. Acupuncture and weight reduction in cases of obesity can be considered.

Effectiveness of social work intervention with a systematic approach to improve general health in opioid addicts in addiction treatment centers

Directory of Open Access Journals (Sweden)

Raheb G

2016-11-01

Full Text Available Ghoncheh Raheb,1,2 Esmat Khaleghi,1 Amir Moghanibashi-Mansourieh,1 Ali Farhoudian,2 Robab Teymouri3 1Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 2Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 3Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Purpose: This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. Patients and methods: This is an experimental plan (pretest to posttest with a control group; the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30 and control (30 groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. Results: A covariance analysis test and independent and dependent t-test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. Conclusion: Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients’ self-understanding and self-recognition, and enhancing social functioning. Keywords: social work, intervention, systematic approach, general health, opioid addicts

Comparative Analytical Utility of DNA Derived from Alternative Human Specimens for Molecular Autopsy and Diagnostics

Science.gov (United States)

Klassen, Tara L.; von Rüden, Eva-Lotta; Drabek, Janice; Noebels, Jeffrey L.; Goldman, Alica M.

2013-01-01

Genetic testing and research have increased the demand for high-quality DNA that has traditionally been obtained by venipuncture. However, venous blood collection may prove difficult in special populations and when large-scale specimen collection or exchange is prerequisite for international collaborative investigations. Guthrie/FTA card–based blood spots, buccal scrapes, and finger nail clippings are DNA-containing specimens that are uniquely accessible and thus attractive as alternative tissue sources (ATS). The literature details a variety of protocols for extraction of nucleic acids from a singular ATS type, but their utility has not been systematically analyzed in comparison with conventional sources such as venous blood. Additionally, the efficacy of each protocol is often equated with the overall nucleic acid yield but not with the analytical performance of the DNA during mutation detection. Together with a critical in-depth literature review of published extraction methods, we developed and evaluated an all-inclusive approach for serial, systematic, and direct comparison of DNA utility from multiple biological samples. Our results point to the often underappreciated value of these alternative tissue sources and highlight ways to maximize the ATS-derived DNA for optimal quantity, quality, and utility as a function of extraction method. Our comparative analysis clarifies the value of ATS in genomic analysis projects for population-based screening, diagnostics, molecular autopsy, medico-legal investigations, or multi-organ surveys of suspected mosaicisms. PMID:22796560

[Alternatives to animal testing].

Science.gov (United States)

Fabre, Isabelle

2009-11-01

The use of alternative methods to animal testing are an integral part of the 3Rs concept (refine, reduce, replace) defined by Russel & Burch in 1959. These approaches include in silico methods (databases and computer models), in vitro physicochemical analysis, biological methods using bacteria or isolated cells, reconstructed enzyme systems, and reconstructed tissues. Emerging "omic" methods used in integrated approaches further help to reduce animal use, while stem cells offer promising approaches to toxicologic and pathophysiologic studies, along with organotypic cultures and bio-artificial organs. Only a few alternative methods can so far be used in stand-alone tests as substitutes for animal testing. The best way to use these methods is to integrate them in tiered testing strategies (ITS), in which animals are only used as a last resort.

An alternative approach to industrial radiography

International Nuclear Information System (INIS)

Broadhead, P.

1981-01-01

An alternative to industrial X-ray film for industrial radiography is described. The experimental system uses film containing approximately 35% of the silver in an industrial type film, which makes the film easier to process, and uses high resolution phosphor screens, which improves the absorption of X-ray photons. Those properties that affect image quality, namely contrast, modulation transfer function and granularity, are discussed in detail for both types of system. A study of low contrast detail in radiographs indicates that for noise limited information the experimental system offers a higher quality than industrial X-ray film of similar speed. (author)

Early Site Permit Demonstration Program: Station design alternatives report

International Nuclear Information System (INIS)

1993-03-01

This report provides the results of investigating the basis for including Station Design Alternatives (SDAs) in the regulatory guidance given for nuclear plant environmental reports (ERs), explains approaches or processes for evaluating SDAs at the early site permit (ESP) stage, and applies one of the processes to each of the ten systems or subsystems considered as SDAS. The key objective o this report s to demonstrate an adequate examination of alternatives can be performed without the extensive development f design data. The report discusses the Composite Suitability Approach and the Established Cutoff Approach in evaluating station design alternatives and selects one of these approaches to evaluate alternatives for each of the plant or station that were considered. Four types of ALWRs have been considered due to the availability of extensive plant data: System 80+, AP600, Advanced Boiling Reactor (ABWR), and Simplified Boiling Water Reactor (SBWR). This report demonstrates the feasibility of evaluating station design alternatives when reactor design detail has not been determined, quantitatively compares the potential ental impacts of alternatives, and focuses the ultimate selection of a alternative on cost and applicant-specific factors. The range of alternatives system is deliberately limited to a reasonable number to demonstrate the or to the three most commonly used at operating plants

Seeing the forests and the trees--innovative approaches to exploring heterogeneity in systematic reviews of complex interventions to enhance health system decision-making: a protocol.

Science.gov (United States)

Ivers, Noah; Tricco, Andrea C; Trikalinos, Thomas A; Dahabreh, Issa J; Danko, Kristin J; Moher, David; Straus, Sharon E; Lavis, John N; Yu, Catherine H; Shojania, Kaveh; Manns, Braden; Tonelli, Marcello; Ramsay, Timothy; Edwards, Alun; Sargious, Peter; Paprica, Alison; Hillmer, Michael; Grimshaw, Jeremy M

2014-08-12

To improve quality of care and patient outcomes, health system decision-makers need to identify and implement effective interventions. An increasing number of systematic reviews document the effects of quality improvement programs to assist decision-makers in developing new initiatives. However, limitations in the reporting of primary studies and current meta-analysis methods (including approaches for exploring heterogeneity) reduce the utility of existing syntheses for health system decision-makers. This study will explore the role of innovative meta-analysis approaches and the added value of enriched and updated data for increasing the utility of systematic reviews of complex interventions. We will use the dataset from our recent systematic review of 142 randomized trials of diabetes quality improvement programs to evaluate novel approaches for exploring heterogeneity. These will include exploratory methods, such as multivariate meta-regression analyses and all-subsets combinatorial meta-analysis. We will then update our systematic review to include new trials and enrich the dataset by surveying authors of all included trials. In doing so, we will explore the impact of variables not, reported in previous publications, such as details of study context, on the effectiveness of the intervention. We will use innovative analytical methods on the enriched and updated dataset to identify key success factors in the implementation of quality improvement interventions for diabetes. Decision-makers will be involved throughout to help identify and prioritize variables to be explored and to aid in the interpretation and dissemination of results. This study will inform future systematic reviews of complex interventions and describe the value of enriching and updating data for exploring heterogeneity in meta-analysis. It will also result in an updated comprehensive systematic review of diabetes quality improvement interventions that will be useful to health system decision

Homogeneous Discrete Time Alternating Compound Renewal Process: A Disability Insurance Application

Directory of Open Access Journals (Sweden)

Guglielmo D’Amico

2015-01-01

Full Text Available Discrete time alternating renewal process is a very simple tool that permits solving many real life problems. This paper, after the presentation of this tool, introduces the compound environment in the alternating process giving a systematization to this important tool. The claim costs for a temporary disability insurance contract are presented. The algorithm and an example of application are also provided.

Systematic Desensitization as a Method of Teaching a General Anxiety-Reducing Skill

Science.gov (United States)

Zemore, Robert

1975-01-01

College students were treated with either a standard or modified version of systematic desensitization. Relative to a no-treatment control group, both treatment methods produced significant reductions in both the treated and untreated fears. The implications these findings have for two alternative conceptions of systematic desensitization are…

A Guide to the Systematic Literature Review Methodology in Supply Chain Management

DEFF Research Database (Denmark)

Durach, Christian F.; Wieland, Andreas; Kembro, Joakim

methodological developments in the application systematic literature reviews in supply chain management. It analyzes what approaches researchers in supply chain management have taken to follow the requirements of a systematic review, identifies issues in the approaches and provides authors, reviewers and editors...... with suggestions to better craft, disseminate, evaluate and select systematic literature reviews in supply chain management. This paper applies a systematic literature review approach to identify and analyze 31 articles published in core supply chain journals. It is the first research to map these developments......, since three seminal methodology papers on systematic reviews in management research have been published between 2003-2009. This research shows that there is still a need for more transparency in the approaches taken. Systematic literature reviews have a high potential to advance the field...

A Systematic Approach for Dynamic Security Assessment and the Corresponding Preventive Control Scheme Based on Decision Trees

DEFF Research Database (Denmark)

Liu, Leo; Sun, Kai; Rather, Zakir Hussain

2014-01-01

This paper proposes a decision tree (DT)-based systematic approach for cooperative online power system dynamic security assessment (DSA) and preventive control. This approach adopts a new methodology that trains two contingency-oriented DTs on a daily basis by the databases generated from power...... system simulations. Fed with real-time wide-area measurements, one DT of measurable variables is employed for online DSA to identify potential security issues, and the other DT of controllable variables provides online decision support on preventive control strategies against those issues. A cost......-effective algorithm is adopted in this proposed approach to optimize the trajectory of preventive control. The paper also proposes an importance sampling algorithm on database preparation for efficient DT training for power systems with high penetration of wind power and distributed generation. The performance...

Sumerian: The Descendant of a Proto-Historical Creole? An Alternative Approach to the "Sumerian Problem." ROLIG-papir 51.

Science.gov (United States)

Hoyrup, Jens

Problems in determining the origins of Sumerian, an ancient language, are described, and an alternative approach is examined. Sumerian was spoken in southern Iraq in the third millennium B.C. and later used by Babylonian and Assyrian scribes as a classical language. While early texts in Sumerian are considered a better reflection of the original…

BUBBLE UP: ALTERNATIVE APPROACHES TO RESEARCH IN THE ACADEMIC ARCHITECTURE STUDIO

Directory of Open Access Journals (Sweden)

Gregory Marinic

2010-07-01

Full Text Available Increased connectivity among the design disciplines has radically transformed the nature of building today. Architectural education must accordingly adapt to the emerging needs of our changing built environment by providing vital, flexible, and open learning environments. Pedagogies in the academy have typically been rooted in practices that are both reluctant to change and slow to address transformative forces in an honest and open manner. Regrettably, the resilience of such top-down methods continues to bias the lens of learning toward natural performers and the notion of singular genius. Authentic attempts to react to new demands and to introduce change are all too often met with both strong resistance and profound contempt by conservative critics. Mainline architectural academia continues to project a deep ambivalence to new methodologies, alternative approaches to context, broadened conceptual practices, and advanced visualization techniques. Yet such means provide a responsive and resilient structure to re-frame content, expedite delivery, and update pedagogical objectives for the next generation.

Extractive text summarization system to aid data extraction from full text in systematic review development.

Science.gov (United States)

Bui, Duy Duc An; Del Fiol, Guilherme; Hurdle, John F; Jonnalagadda, Siddhartha

2016-12-01

Extracting data from publication reports is a standard process in systematic review (SR) development. However, the data extraction process still relies too much on manual effort which is slow, costly, and subject to human error. In this study, we developed a text summarization system aimed at enhancing productivity and reducing errors in the traditional data extraction process. We developed a computer system that used machine learning and natural language processing approaches to automatically generate summaries of full-text scientific publications. The summaries at the sentence and fragment levels were evaluated in finding common clinical SR data elements such as sample size, group size, and PICO values. We compared the computer-generated summaries with human written summaries (title and abstract) in terms of the presence of necessary information for the data extraction as presented in the Cochrane review's study characteristics tables. At the sentence level, the computer-generated summaries covered more information than humans do for systematic reviews (recall 91.2% vs. 83.8%, p<0.001). They also had a better density of relevant sentences (precision 59% vs. 39%, p<0.001). At the fragment level, the ensemble approach combining rule-based, concept mapping, and dictionary-based methods performed better than individual methods alone, achieving an 84.7% F-measure. Computer-generated summaries are potential alternative information sources for data extraction in systematic review development. Machine learning and natural language processing are promising approaches to the development of such an extractive summarization system. Copyright © 2016 Elsevier Inc. All rights reserved.

'Medical ethics'--an alternative approach.

Science.gov (United States)

Haldane, J J

1986-01-01

Contemporary medical ethics is generally concerned with the application of ethical theory to medico-moral dilemmas and with the critical analysis of the concepts of medicine. This paper presents an alternative programme: the development of a medical philosophy which, by taking as its starting point the two questions: what is man? and, what constitutes goodness in life? offers an account of health as one of the primary concepts of value. This view of the subject resembles that implied by ancient theories of goodness, and in later sections of the paper it is shown how Aristotle points us towards a coherent theory of human nature as psycho-physical, which overcomes the inadequacies of dualism and physicalist reductionism. What is on offer therefore, is the prospect of an integrated account of human nature and of what constitutes its flourishing: to be healthy is to be an active unity-of-parts in equilibrium. PMID:3761336

Values-led Participatory Design as a pursuit of meaningful alternatives

DEFF Research Database (Denmark)

Leong, Tuck Wah; Iversen, Ole Sejer

2015-01-01

Participatory Design (PD) is inherently concerned with inquiring into and supporting human values when designing IT. We argue that a PD approach that is led by a focus upon participants' values can allow participants to discover meaningful alternatives -- alternative uses and alternative...... conceptualizations for IT that are particularly meaningful to them. However, how PD works with values in the design process has not been made explicit. In this paper, we aim to (i) explicate this values-led PD approach, (ii) illustrate how this approach can lead to outcomes that are meaningful alternatives, and (iii...

HLW Salt Disposition Alternatives Identification Preconceptual Phase I Summary Report (Including Attachments)

International Nuclear Information System (INIS)

Piccolo, S.F.

1999-01-01

The purpose of this report is to summarize the process used by the Team to systematically develop alternative methods or technologies for final disposition of HLW salt. Additionally, this report summarizes the process utilized to reduce the total list of identified alternatives to an ''initial list'' for further evaluation. This report constitutes completion of the team charter major milestone Phase I Deliverable

The soft computing-based approach to investigate allergic diseases: a systematic review.

Science.gov (United States)

Tartarisco, Gennaro; Tonacci, Alessandro; Minciullo, Paola Lucia; Billeci, Lucia; Pioggia, Giovanni; Incorvaia, Cristoforo; Gangemi, Sebastiano

2017-01-01

Early recognition of inflammatory markers and their relation to asthma, adverse drug reactions, allergic rhinitis, atopic dermatitis and other allergic diseases is an important goal in allergy. The vast majority of studies in the literature are based on classic statistical methods; however, developments in computational techniques such as soft computing-based approaches hold new promise in this field. The aim of this manuscript is to systematically review the main soft computing-based techniques such as artificial neural networks, support vector machines, bayesian networks and fuzzy logic to investigate their performances in the field of allergic diseases. The review was conducted following PRISMA guidelines and the protocol was registered within PROSPERO database (CRD42016038894). The research was performed on PubMed and ScienceDirect, covering the period starting from September 1, 1990 through April 19, 2016. The review included 27 studies related to allergic diseases and soft computing performances. We observed promising results with an overall accuracy of 86.5%, mainly focused on asthmatic disease. The review reveals that soft computing-based approaches are suitable for big data analysis and can be very powerful, especially when dealing with uncertainty and poorly characterized parameters. Furthermore, they can provide valuable support in case of lack of data and entangled cause-effect relationships, which make it difficult to assess the evolution of disease. Although most works deal with asthma, we believe the soft computing approach could be a real breakthrough and foster new insights into other allergic diseases as well.

Substitution of sugar-sweetened beverages with other beverage alternatives

DEFF Research Database (Denmark)

Zheng, Miaobing; Allman-Farinelli, Margaret; Heitmann, Berit Lilienthal

2015-01-01

alternatives on long-term health outcomes. METHOD: We systematically retrieved studies from six electronic databases from inception to November 2013. Prospective cohort studies and randomized controlled trials (RCTs) examining the effects of substituting beverage alternatives for SSBs on long-term health...... to high. Evidence from both cohort studies and RCTs showed substitution of SSBs by various beverage alternatives was associated with long-term lower energy intake and lower weight gain. However, evidence was insufficient to draw conclusions regarding the effect of beverage substitution on other health...... outcomes, and which beverage alternative is the best choice. CONCLUSIONS: Although studies on this topic are sparse, the available evidence suggests a potential beneficial effect on body weight outcomes when SSBs are replaced by water or low-calorie beverages. Further studies in this area are warranted...

Task to Training Matrix Design for Decommissioning Engineer on the basis of Systematic Approach to Training Methodology

Energy Technology Data Exchange (ETDEWEB)

Kwak, Jeong Keun [KHNP, Ulsan (Korea, Republic of)

2016-10-15

In nuclear history, before Chernobyl Accident, Three Mile Island (TMI) Accident was the severest accident. For this reason, to resolve the disclosed or potential possibilities of nuclear accident, more than one hundred countermeasures were proposed by United States Nuclear Regulatory Commission (USNRC). Among various recommendations by USNRC, one suggestion was related to training aspect. It was Systematic Approach to Training (SAT) and this event was the initiation of SAT methodology in the world. In Korea, upcoming June 2017, Kori Unit-1 NPP is scheduled to be shut down and it will experience NPP decommissioning for the first time. Present study aims to establish concrete training foundation for NPP decommissioning engineers based on Systematic Approach to Training (SAT) methodology, in particular, Task to Training Matrix (TTM). The objective of this paper is to organize TTM on the basis of SAT for NPP decommissioning engineer. For this reason, eighteen tasks are yielded through Job and Task Analysis (JTA) process. After that, for the settlement of Task to Training Matrix (TTM), various data are determined such as element, condition, standard, knowledge and skill, learning objective and training setting. When it comes to training in nuclear industry, SAT methodology has been the unwavering principle in Korea since NPPs export to UAE.

Limits of Risk Predictability in a Cascading Alternating Renewal Process Model.

Science.gov (United States)

Lin, Xin; Moussawi, Alaa; Korniss, Gyorgy; Bakdash, Jonathan Z; Szymanski, Boleslaw K

2017-07-27

Most risk analysis models systematically underestimate the probability and impact of catastrophic events (e.g., economic crises, natural disasters, and terrorism) by not taking into account interconnectivity and interdependence of risks. To address this weakness, we propose the Cascading Alternating Renewal Process (CARP) to forecast interconnected global risks. However, assessments of the model's prediction precision are limited by lack of sufficient ground truth data. Here, we establish prediction precision as a function of input data size by using alternative long ground truth data generated by simulations of the CARP model with known parameters. We illustrate the approach on a model of fires in artificial cities assembled from basic city blocks with diverse housing. The results confirm that parameter recovery variance exhibits power law decay as a function of the length of available ground truth data. Using CARP, we also demonstrate estimation using a disparate dataset that also has dependencies: real-world prediction precision for the global risk model based on the World Economic Forum Global Risk Report. We conclude that the CARP model is an efficient method for predicting catastrophic cascading events with potential applications to emerging local and global interconnected risks.

Hierarchical eco-restoration: A systematical approach to removal of COD and dissolved nutrients from an intensive agricultural area

Energy Technology Data Exchange (ETDEWEB)

Wu Yonghong, E-mail: yhwu@issas.ac.c [State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, 71 Beijing East Road, Nanjing 210008 (China); Graduate Schools, Chinese Academy of Sciences, Beijing 100049 (China); Hu Zhengyi [Graduate Schools, Chinese Academy of Sciences, Beijing 100049 (China); Yang Linzhang, E-mail: lzyang@issas.ac.c [State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, 71 Beijing East Road, Nanjing 210008 (China)

2010-10-15

A systematical approach based on hierarchical eco-restoration system for the simultaneous removal of COD and dissolved nutrients was proposed and applied in a complex residential-cropland area in Kunming, China from August 2006 to August 2008, where the self-purifying capacity of the agricultural ecosystem had been lost. The system includes four main parts: (1) fertilizer management and agricultural structure optimization, (2) nutrients reuse, (3) wastewater treatment, and (4) catchment restoration. The results showed that the average removal efficiencies were 90% for COD, 93% for ammonia, 94% for nitrate and 71% for total dissolved phosphorus (TDP) when the hierarchical eco-restoration agricultural system was in a relatively steady-state condition. The emergence of 14 species of macrophytes and 4 species of zoobenthos indicated that the growth conditions for the plankton were improved. The results demonstrated that this promising and environmentally benign hierarchical eco-restoration system could decrease the output of nutrients and reduce downstream eutrophication risk. - A systematical approach based on hierarchical eco-restoration system has proven highly effective for simultaneously removing COD and dissolved nutrients, decreasing the output of nutrients, and reducing the eutrophic risk of downstream surface waters.

Hierarchical eco-restoration: A systematical approach to removal of COD and dissolved nutrients from an intensive agricultural area

International Nuclear Information System (INIS)

Wu Yonghong; Hu Zhengyi; Yang Linzhang

2010-01-01

A systematical approach based on hierarchical eco-restoration system for the simultaneous removal of COD and dissolved nutrients was proposed and applied in a complex residential-cropland area in Kunming, China from August 2006 to August 2008, where the self-purifying capacity of the agricultural ecosystem had been lost. The system includes four main parts: (1) fertilizer management and agricultural structure optimization, (2) nutrients reuse, (3) wastewater treatment, and (4) catchment restoration. The results showed that the average removal efficiencies were 90% for COD, 93% for ammonia, 94% for nitrate and 71% for total dissolved phosphorus (TDP) when the hierarchical eco-restoration agricultural system was in a relatively steady-state condition. The emergence of 14 species of macrophytes and 4 species of zoobenthos indicated that the growth conditions for the plankton were improved. The results demonstrated that this promising and environmentally benign hierarchical eco-restoration system could decrease the output of nutrients and reduce downstream eutrophication risk. - A systematical approach based on hierarchical eco-restoration system has proven highly effective for simultaneously removing COD and dissolved nutrients, decreasing the output of nutrients, and reducing the eutrophic risk of downstream surface waters.

Random spectrum loading of dental implants: An alternative approach to functional performance assessment.

Science.gov (United States)

Shemtov-Yona, K; Rittel, D

2016-09-01

The fatigue performance of dental implants is usually assessed on the basis of cyclic S/N curves. This neither provides information on the anticipated service performance of the implant, nor does it allow for detailed comparisons between implants unless a thorough statistical analysis is performed, of the kind not currently required by certification standards. The notion of endurance limit is deemed to be of limited applicability, given unavoidable stress concentrations and random load excursions, that all characterize dental implants and their service conditions. We propose a completely different approach, based on random spectrum loading, as long used in aeronautical design. The implant is randomly loaded by a sequence of loads encompassing all load levels it would endure during its service life. This approach provides a quantitative and comparable estimate of its performance in terms of lifetime, based on the very fact that the implant will fracture sooner or later, instead of defining a fatigue endurance limit of limited practical application. Five commercial monolithic Ti-6Al-4V implants were tested under cyclic, and another 5 under spectrum loading conditions, at room temperature and dry air. The failure modes and fracture planes were identical for all implants. The approach is discussed, including its potential applications, for systematic, straightforward and reliable comparisons of various implant designs and environments, without the need for cumbersome statistical analyses. It is believed that spectrum loading can be considered for the generation of new standardization procedures and design applications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Public health terminology: Hindrance to a Health in All Policies approach?

Science.gov (United States)

Synnevåg, Ellen S; Amdam, Roar; Fosse, Elisabeth

2018-02-01

National public health policies in Norway are based on a Health in All Policies (HiAP) approach. At the local level, this means that public health, as a cross-sectional responsibility, should be implemented in all municipal sectors by integrating public health policies in municipal planning and management systems. The paper investigates these local processes, focusing on the use of public health terminology and how this terminology is translated from national to local contexts. We ask whether the terms 'public health' and 'public health work' are suitable when implementing an HiAP approach. A qualitative case study based on analyses of interviews and planning documents was performed in three Norwegian municipalities. The results present dilemmas associated with using public health terminology when implementing an HiAP approach. On the one hand, the terms are experienced as wide, complex, advanced and unnecessary. On the other hand, the terms are experienced as important for a systematic approach towards understanding public health ideology and cross-sectional responsibility. One municipality used alternative terminology. This paper promotes debate about the appropriateness of using the terms 'public health' and 'public health work' at the local level. It suggests that adaptation is suitable and necessary, unless it compromises knowledge, responsibility and a systematic approach. This study concludes that the use of terminology is a central factor when implementing the Norwegian Public Health Act at the local level.

Global warming and energy technology choices: An approach to weighing the alternatives

International Nuclear Information System (INIS)

DeGroat, K.J.

1991-01-01

Responses to global warming must be fashioned in the face of great uncertainty as to the actual costs and benefits of the actions. Yet the possible consequences of inaction are so great that policy makers are having to move ahead on the basis of science's incomplete knowledge of the true impacts of global warming. Energy technology is a key component of any response becauseof fossil fuels' dominant role in generating the gases that are the cause of the greenhouse effect. This paper presents an approach to analyzing CO 2 emissions from both fossil fuel and alternative energy technologies on a basis that normalizes emissions as a function of useful power output over the life of a generating technology, and over its entire fuel cycle. A scenario for analyzing wood-fired electricity generation from a short-rotation wood plantation is developed in detail to illustrate the application of the approach to assessing the CO 2 impact of biomass energy. The paper concludes that wood energy supplied by a short-rotation woody plantation not only balances the emissions during the operation of the generating plant, but also sequesters CO 2 in the 'infrastructure' of growing biomass that remains on the plantation after harvesting. The paper finishes with a caution that this analysis tends to highlight only the environmental issues involved in technology selection; economics, technical feasibility and important technical parameters are intentionally simplified in order to focus attention on emissions and power output. However, if used properly this approach does provide useful inputs for policy makers concerned with integrating environmental concerns into energy decisions

Exploiting science? A systematic analysis of complementary and alternative medicine clinic websites' marketing of stem cell therapies.

Science.gov (United States)

Murdoch, Blake; Zarzeczny, Amy; Caulfield, Timothy

2018-02-28

To identify the frequency and qualitative characteristics of stem cell-related marketing claims made on websites of clinics featuring common types of complementary and alternative medicine practitioners. The involvement of complementary and alternative medicine practitioners in the marketing of stem cell therapies and stem cell-related interventions is understudied. This research explores the extent to which they are involved and collaborate with medical professionals. This knowledge will help with identifying and evaluating potential policy responses to this growing market. Systematic website analysis. Global. US and English-language bias due to methodology. Representations made on clinic websites in relation to practitioner types, stem cell therapies and their targets, stem cell-related interventions. Statements about stem cell therapies relating to evidence of inefficacy, limited evidence of efficacy, general procedural risks, risks specific to the mode of therapy, regulatory status, experimental or unproven nature of therapy. Use of hype language (eg, language that exaggerates potential benefits). 243 websites offered stem cell therapies. Many websites advertised stem cell transplantation from multiple sources, such as adipose-derived (112), bone marrow-derived (100), blood-derived (28), umbilical cord-derived (26) and others. Plant stem cell-based treatments and products (20) were also advertised. Purposes for and targets of treatment included pain, physical injury, a wide range of diseases and illnesses, cosmetic concerns, non-cosmetic ageing, sexual enhancement and others. Medical doctors (130), chiropractors (53) and naturopaths (44) commonly work in the clinics we found to be offering stem cell therapies. Few clinic websites advertising stem cell therapies included important additional information, including statements about evidence of inefficacy (present on only 12.76% of websites), statements about limited evidence of efficacy (18.93%), statements of

Israeli nurses' attitudes to the holistic approach to health and their use of complementary and alternative therapies.

Science.gov (United States)

Orkaby, Brurya; Greenberger, Chaya

2015-03-01

To examine nurses' attitudes to holistic and biomedical approaches to health care and the correlation between the two and to explore the extent of recommending and using complementary and alternative medicine (CAM) by nurses and its correlation with attitudes toward the holistic approach to care. In this cross-sectional correlational study, a structured questionnaire was completed anonymously by 213 Israeli hospital-based nurses from various departments. Nurses perceived both approaches as critical to optimal health care: a positive correlation emerged of attitudes to the two approaches. Nurses recommended and used CAM extensively; most therapies were recommended and/or used by 70% or more of the respondents. Nurses with more positive attitudes toward holistic care tended to recommend and use CAM to a greater extent. Biomedical and holistic approaches are perceived by nurses to coexist within nursing professional boundaries and form a broad basis for optimal health care. Nurses' attitudes to the holistic approach appear to promote recommendation and/or use of CAM in practice. More training in CAM should be offered in nursing educational frameworks and research should continue to establish evidence for CAM's effectiveness. © The Author(s) 2014.

Systematic Approach to Better Understanding Integration Costs

Energy Technology Data Exchange (ETDEWEB)

Stark, Gregory B. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2015-09-01

This research presents a systematic approach to evaluating the costs of integrating new generation and operational procedures into an existing power system, and the methodology is independent of the type of change or nature of the generation. The work was commissioned by the U.S. Department of Energy and performed by the National Renewable Energy Laboratory to investigate three integration cost-related questions: (1) How does the addition of new generation affect a system's operational costs, (2) How do generation mix and operating parameters and procedures affect costs, and (3) How does the amount of variable generation (non-dispatchable wind and solar) impact the accuracy of natural gas orders? A detailed operational analysis was performed for seven sets of experiments: variable generation, large conventional generation, generation mix, gas prices, fast-start generation, self-scheduling, and gas supply constraints. For each experiment, four components of integration costs were examined: cycling costs, non-cycling VO&M costs, fuel costs, and reserves provisioning costs. The investigation was conducted with PLEXOS production cost modeling software utilizing an updated version of the Institute of Electrical and Electronics Engineers 118-bus test system overlaid with projected operating loads from the Western Electricity Coordinating Council for the Sacramento Municipal Utility District, Puget Sound Energy, and Public Service Colorado in the year 2020. The test system was selected in consultation with an industry-based technical review committee to be a reasonable approximation of an interconnection yet small enough to allow the research team to investigate a large number of scenarios and sensitivity combinations. The research should prove useful to market designers, regulators, utilities, and others who want to better understand how system changes can affect production costs.

Alternative approaches to vertebrate ecotoxicity tests in the 21st century: A review of developments over the last 2 decades and current status

Science.gov (United States)

Lillicrap, Adam; Belanger, Scott; Burden, Natalie; Du Pasquier, David; Embry, Michelle; Halder, Marlies; Lampi, Mark; Lee, Lucy; Norberg-King, Teresa J.; Rattner, Barnett A.; Schirmer, Kristin; Thomas, Paul

2016-01-01

The need for alternative approaches to the use of vertebrate animals for hazard assessment of chemicals and pollutants has become of increasing importance. It is now the first consideration when initiating a vertebrate ecotoxicity test, to ensure that unnecessary use of vertebrate organisms is minimized wherever possible. For some regulatory purposes, the use of vertebrate organisms for environmental risk assessments has been banned; in other situations, the number of organisms tested has been dramatically reduced or the severity of the procedure refined. However, there is still a long way to go to achieve a complete replacement of vertebrate organisms to generate environmental hazard data. The development of animal alternatives is based not just on ethical considerations but also on reducing the cost of performing vertebrate ecotoxicity tests and in some cases on providing better information aimed at improving environmental risk assessments. The present Focus article provides an overview of the considerable advances that have been made toward alternative approaches for ecotoxicity assessments over the last few decades.

Radiation protection in nuclear facilities. Complexity versus systematic approach; Strahlenschutz in Kernanlagen. Komplexitaet versus Systematik

Energy Technology Data Exchange (ETDEWEB)

Jahn, S.G. [Eidgenoessisches Nuklearsicherheitsinspektorat (ENSI), Brugg (Switzerland)

2016-07-01

Considering the amount of radiation sources in nuclear power plants, their chemical and physical state, the miscellaneous exposure pathways as well as varying limits, reference values and constraints for the protection of persons, tissues and environment, the number of different exposure situations per year ranges up to several thousands. With this complexity a systematic approach for planning a new facility, modification, decommissioning or operation is necessary to ensure complete radiation protection without gaps. The Swiss federal nuclear safety inspectorate (ENSI) is developing and testing a system of safety objectives, functions and measures, which is complementary to the IAEA fundamental safety objectives and requirements.

Noninvasive inductive stent heating: alternative approach to prevent instent restenosis?

Science.gov (United States)

Floren, Michael G; Günther, Rolf W; Schmitz-Rode, Thomas

2004-05-01

To test noninvasive inductive heating of implanted vascular stents as an alternative approach for reduction or prevention of neointimal hyperplasia. Calorimetric pretests were performed to get an orientation on the different parameters of influence for inductive heating of stents. The field strength was set to a maximum of 90 kA/m within a frequency range from 80 kHz to 320 kHz. The electromagnetic field was emitted by a custom-made water-cooled copper winding antenna. A flow model for stent heating was set up to assess the increase in temperature of an expanded 316L stainless steel stent with typical coronary stent dimensions of 3.5 mm diameter and 14.5 mm in length, and in a second setup with 4.5 mm diameter and 13 mm in length, respectively. The stent was located in a bioartificial artery, simulated by a fibrinogen matrix with a defined number of vital cells. The system was exposed to a pulsating perfusion and to an electromagnetic field of 200 kHz over a period of 20 minutes and in a second setup to an electromagnetic field of 300 kHz and increasing intensity up to maximum power-output. Afterward, the artificial vessel was sliced and examined by fluorescence microscopy to evaluate the number and location of damaged cells. The calorimetric tests show an exponential correlation of energy uptake in the stent with an increase in frequency and a constant generator output. At a frequency of 80 kHz, the power uptake accounts for 0.1 W (250 kHz 1.0 W; 320 kHz 1.9 W, respectively). The flow tests confirmed feasibility to elevate the stent temperature from 37 degrees C body temperature to 44 degrees C at 200 kHz within 55 seconds. The temperature increase of the fluid passing the heated vessel region was only marginal (maximum of 0.5 degrees C). Cell necrosis after 20 minutes of treatment was not observed. In a second set-up with 4.5 mm stent diameter, a frequency of 300 kHz and with maximum power output, the stent temperature was increased to 80 degrees C and there was

A systematic approach to assessing measurement uncertainty for CO2 emissions from coal-fired power plants

DEFF Research Database (Denmark)

Wagner, Claas; Esbensen, Kim

2011-01-01

An augmented measurement uncertainty approach for CO2 emissions from coal-fired power plants with a focus on the often forgotten contributions from sampling errors occurring over the entire fuel-to-emission pathway is presented. Current methods for CO2 emission determination are evaluated in detail......, from which a general matrix scheme is developed that includes all factors and stages needed for total CO2 determination, which is applied to the monitoring plan of a representative medium-sized coal-fired power plant. In particular sampling involved significant potential errors, as identified...... of these three materials were also given full attention. A systematic error (bias) is present in the current sampling approach, which increases the present uncertainty estimate unnecessarily. For both primary sampling and analytical sample extraction steps, random variations, which hitherto only have been...

Nurses' job dissatisfaction and turnover intention: methodological myths and an alternative approach.

Science.gov (United States)

Takase, Miyuki; Maude, Phillip; Manias, Elizabeth

2005-09-01

Job dissatisfaction and turnover are recurring themes in nursing. The current international nursing shortage has resulted in increased interest in investigating the causes of nurses' job dissatisfaction and turnover, and in developing countermeasures to address these issues. This paper involves a review of quantitative nursing studies, which investigated the causes of nurses' job dissatisfaction and turnover intention, and identifies commonly held myths that may inhibit more nurse-centered strategies from being developed. These myths are based on an assumption that a nurse-environment relationship is a one-way interaction in which nurses passively respond to their environment. The paper introduces the person-environment fit theory as an alternative framework, which challenges the assumption by suggesting it is the relationship between person and environment, rather than environmental characteristics alone, that affects nurses' occupational behavior. This theory enables nurse researchers to develop a more mutual approach involving the nurse and environment.

A systematic grounded approach to the development of complex interventions: the Australian WorkHealth Program--arthritis as a case study.

Science.gov (United States)

Reavley, Nicola; Livingston, Jenni; Buchbinder, Rachelle; Bennell, Kim; Stecki, Chris; Osborne, Richard Harry

2010-02-01

Despite demands for evidence-based research and practice, little attention has been given to systematic approaches to the development of complex interventions to tackle workplace health problems. This paper outlines an approach to the initial stages of a workplace program development which integrates health promotion and disease management. The approach commences with systematic and genuine processes of obtaining information from key stakeholders with broad experience of these interventions. This information is constructed into a program framework in which practice-based and research-informed elements are both valued. We used this approach to develop a workplace education program to reduce the onset and impact of a common chronic disease - osteoarthritis. To gain information systematically at a national level, a structured concept mapping workshop with 47 participants from across Australia was undertaken. Participants were selected to maximise the whole-of-workplace perspective and included health education providers, academics, clinicians and policymakers. Participants generated statements in response to a seeding statement: Thinking as broadly as possible, what changes in education and support should occur in the workplace to help in the prevention and management of arthritis? Participants grouped the resulting statements into conceptually coherent groups and a computer program was used to generate a 'cluster map' along with a list of statements sorted according to cluster membership. In combination with research-based evidence, the concept map informed the development of a program logic model incorporating the program's guiding principles, possible service providers, services, training modes, program elements and the causal processes by which participants might benefit. The program logic model components were further validated through research findings from diverse fields, including health education, coaching, organisational learning, workplace interventions

Selection of remedial alternatives for mine sites: a multicriteria decision analysis approach.

Science.gov (United States)

Betrie, Getnet D; Sadiq, Rehan; Morin, Kevin A; Tesfamariam, Solomon

2013-04-15

The selection of remedial alternatives for mine sites is a complex task because it involves multiple criteria and often with conflicting objectives. However, an existing framework used to select remedial alternatives lacks multicriteria decision analysis (MCDA) aids and does not consider uncertainty in the selection of alternatives. The objective of this paper is to improve the existing framework by introducing deterministic and probabilistic MCDA methods. The Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE) methods have been implemented in this study. The MCDA analysis involves processing inputs to the PROMETHEE methods that are identifying the alternatives, defining the criteria, defining the criteria weights using analytical hierarchical process (AHP), defining the probability distribution of criteria weights, and conducting Monte Carlo Simulation (MCS); running the PROMETHEE methods using these inputs; and conducting a sensitivity analysis. A case study was presented to demonstrate the improved framework at a mine site. The results showed that the improved framework provides a reliable way of selecting remedial alternatives as well as quantifying the impact of different criteria on selecting alternatives. Copyright © 2013 Elsevier Ltd. All rights reserved.

Coaching Humanistically: An Alternative Approach.

Science.gov (United States)

Danziger, Raymond Curtis

1982-01-01

Four goals for a humanistic approach to athletics are: (1) elevating perception of students' physical abilities to improve self-esteem; (2) encouraging self-actualization; (3) contributing to self-understanding; and (4) improving interpersonal relationships. Implications of these objectives for team management, competition, and the attitudes of…

Complementary and Alternative Approaches to Pain Relief during Labor

Directory of Open Access Journals (Sweden)

Michel Tournaire

2007-01-01

Full Text Available This review evaluated the effect of complementary and alternative medicine on pain during labor with conventional scientific methods using electronic data bases through 2006 were used. Only randomized controlled trials with outcome measures for labor pain were kept for the conclusions. Many studies did not meet the scientific inclusion criteria. According to the randomized control trials, we conclude that for the decrease of labor pain and/or reduction of the need for conventional analgesic methods: (i There is an efficacy found for acupressure and sterile water blocks. (ii Most results favored some efficacy for acupuncture and hydrotherapy. (iii Studies for other complementary or alternative therapies for labor pain control have not shown their effectiveness.

The use of GRADE approach in systematic reviews of animal studies.

Science.gov (United States)

Wei, Dang; Tang, Kun; Wang, Qi; Estill, Janne; Yao, Liang; Wang, Xiaoqin; Chen, Yaolong; Yang, Kehu

2016-03-15

The application of GRADE (Grading of Recommendations Assessment, Development and Evaluation) in SR of animal studies can promote the translation from bench to bedside. We aim to explore the use of GRADE in systematic reviews of animal studies. We used a theoretical analysis method to explore the use of GRADE in SR of animal studies and applied in a SR of animal studies. Meanwhile, we presented and discussed our results in two international conferences. Five downgrade factors were considered as follows in systematic reviews of animal studies: 1) Risk of bias: the SYRCLE tool can be used for assessing the risk of bias of animal studies. 2) Indirectness: we can assess indirectness in systematic reviews of animal studies from the PICO. 3) Inconsistency: similarity of point estimates, extent of overlap of confidence intervals and statistical heterogeneity are also suitable to evaluate inconsistency of evidence from animal studies. 4) Imprecision: optimal information size (OIS) and 95% confidence intervals (CIs) are also suitable for systematic reviews of animal studies, like those of clinical trials. 5) Publication bias: we need to consider publication bias comprehensively through the qualitative and quantitative methods. The methods about the use of GRADE in systematic review of animal studies are explicit. However, the principle about GRADE in developing the policy based on the evidence from animal studies when there is an emergency of public health. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Ordering alternatives in MCDM problems

International Nuclear Information System (INIS)

De Baets, B.

1994-01-01

A new approach to the study of a set of alternatives in a multi-criteria decision making problem is presented. Alternatives are described by means of fuzzy sets in the set of criteria, expressing the degrees to which they fulfill the different criteria. The concept of a fuzzy inclusion is introduced and is discussed from an axiomatic point of view. To each implication operator corresponds a fuzzy inclusion. The fuzzy inclusion corresponding to the Goedel operator is used to measure the degree to which the scores of one alternative are contained in the scores of another one. Repeating this for all couples of alternatives yields a fuzzy quasi-order relation in a set of alternatives. The cuts of this fuzzy relation are then classical quasi-order relations: they express orderings of the alternatives, allowing alternatives to be indifferent or incomparable, corresponding to different degrees of confidence

A Modern Approach to the Elaboration and Selection of Strategic Alternatives for Resource Regions

Directory of Open Access Journals (Sweden)

Valeriy Anatolyevich Kryukov

2017-03-01

Full Text Available For many countries and regions (both in Russia and abroad, natural resources are the crucial factor for socio-economic development. The role and significance of natural resources in the economy of different areas substantially depend on the institutional environment, including the resource regime. Today, we have a qualitative complication of conditions for mineral resources exploitation, we start to develop new, non-traditional types of resources, which haven’t been available (or demanded earlier for the economic and technological reasons. The changes in the characteristics of natural objects, as well as the increasing of uncertainty in the resource sector, actualize the search for alternatives of the development of resource-type regions and for the elaboration of appropriate strategies. In new conditions of resource regions, it is necessary to place emphasis on the aspects of expanded specific understanding of inclusiveness. It implies the possibility of active participation of regional authorities in the management and regulation of the mineral complex, as well as their involvement in the development of the association of a wide range of communities. These communities consist of the organizations representing the interests of indigenous peoples as well as professional communities: industry associations, environmental organizations, representatives of the innovation industry. Modern approaches to the elaboration of strategic directions for the resource regions development (primarily based on the development of the mineral industry should be based on sustainable development principles, the principles of inclusiveness and the need for innovations. As a result of the convergence of these characteristics, a new socio-economic concept is formed. This concept can be defined as the harmonious development that is extremely important for the Russian regions. The proposed approach can be used for the elaboration of strategic alternatives of the

A novel approach to non-biased systematic random sampling: a stereologic estimate of Purkinje cells in the human cerebellum.

Science.gov (United States)

Agashiwala, Rajiv M; Louis, Elan D; Hof, Patrick R; Perl, Daniel P

2008-10-21

Non-biased systematic sampling using the principles of stereology provides accurate quantitative estimates of objects within neuroanatomic structures. However, the basic principles of stereology are not optimally suited for counting objects that selectively exist within a limited but complex and convoluted portion of the sample, such as occurs when counting cerebellar Purkinje cells. In an effort to quantify Purkinje cells in association with certain neurodegenerative disorders, we developed a new method for stereologic sampling of the cerebellar cortex, involving calculating the volume of the cerebellar tissues, identifying and isolating the Purkinje cell layer and using this information to extrapolate non-biased systematic sampling data to estimate the total number of Purkinje cells in the tissues. Using this approach, we counted Purkinje cells in the right cerebella of four human male control specimens, aged 41, 67, 70 and 84 years, and estimated the total Purkinje cell number for the four entire cerebella to be 27.03, 19.74, 20.44 and 22.03 million cells, respectively. The precision of the method is seen when comparing the density of the cells within the tissue: 266,274, 173,166, 167,603 and 183,575 cells/cm3, respectively. Prior literature documents Purkinje cell counts ranging from 14.8 to 30.5 million cells. These data demonstrate the accuracy of our approach. Our novel approach, which offers an improvement over previous methodologies, is of value for quantitative work of this nature. This approach could be applied to morphometric studies of other similarly complex tissues as well.

Systematic Review Methodology in Higher Education

Science.gov (United States)

Bearman, Margaret; Smith, Calvin D.; Carbone, Angela; Slade, Susan; Baik, Chi; Hughes-Warrington, Marnie; Neumann, David L.

2012-01-01

Systematic review methodology can be distinguished from narrative reviews of the literature through its emphasis on transparent, structured and comprehensive approaches to searching the literature and its requirement for formal synthesis of research findings. There appears to be relatively little use of the systematic review methodology within the…

School-Based Interventions Going Beyond Health Education to Promote Adolescent Health: Systematic Review of Reviews.

Science.gov (United States)

Shackleton, Nichola; Jamal, Farah; Viner, Russell M; Dickson, Kelly; Patton, George; Bonell, Christopher

2016-04-01

Health education in school classrooms can be effective in promoting sexual health and preventing violence and substance use but effects are patchy and often short term. Classroom education is also challenging because of schools' increasing focus on academic-performance metrics. Other school-based approaches are possible, such as healthy school policies, improving how schools respond to bullying, and parent outreach, which go beyond health education to address broader health determinants. Existing systematic reviews include such interventions but often alongside traditional health education. There is scope for a systematic review of reviews to assess and synthesize evidence across existing reviews to develop an overview of the potential of alternative school-based approaches. We searched 12 databases to identify reviews published after 1980. Data were reviewed by two researchers. Quality was assessed using a modified Assessing the Methodological Quality of Systematic Reviews checklist and results were synthesized narratively. We screened 7,544 unique references and included 22 reviews. Our syntheses suggest that multicomponent school-based interventions, for example, including school policy changes, parent involvement, and work with local communities, are effective for promoting sexual health and preventing bullying and smoking. There is less evidence that such intervention can reduce alcohol and drug use. Economic incentives to keep girls in school can reduce teenage pregnancies. School clinics can promote smoking cessation. There is little evidence that, on their own, sexual-health clinics, antismoking policies, and various approaches targeting at-risk students are effective. There is good evidence that various whole-school health interventions are effective in preventing teenage pregnancy, smoking, and bullying. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A Systematic Approach to Identify Candidate Transcription Factors that Control Cell Identity

Directory of Open Access Journals (Sweden)

Ana C. D’Alessio

2015-11-01

Full Text Available Hundreds of transcription factors (TFs are expressed in each cell type, but cell identity can be induced through the activity of just a small number of core TFs. Systematic identification of these core TFs for a wide variety of cell types is currently lacking and would establish a foundation for understanding the transcriptional control of cell identity in development, disease, and cell-based therapy. Here, we describe a computational approach that generates an atlas of candidate core TFs for a broad spectrum of human cells. The potential impact of the atlas was demonstrated via cellular reprogramming efforts where candidate core TFs proved capable of converting human fibroblasts to retinal pigment epithelial-like cells. These results suggest that candidate core TFs from the atlas will prove a useful starting point for studying transcriptional control of cell identity and reprogramming in many human cell types.

Alternative approach for establishing the Nacelle Transfer Function

DEFF Research Database (Denmark)

Krishna, Vinay B.; Ormel, Frank; Hansen, Kurt Schaldemose

2016-01-01

The IEC 61400-12-2:2013 is an alternative for all the power performance measurements and analysis when the requirements of the IEC 61400-12-1:2005 are not met. The methodology in the IEC 61400-12-2 standard is solely based on the nacelle anemometry instead of the more traditional methods involving...

The voice of the elderly in accepting alternative perspectives on oral health.

Science.gov (United States)

Brondani, M

2010-09-01

As we age, the dynamic balance between gains and losses has been acknowledged by current portrayals of health. Oral health research has yet to fully incorporate such dynamism in understanding the impact of oral disorders on the life of elders. to explore the existence of alternative views on oral health through values, beliefs and behaviors of older adults. Focus group discussions occurred among 42 men and women between the ages of 64 and 93 years old. Participants were from community and seniors centres and retirement homes. Each discussion lasted for about 90 minutes and was tape-recorded for verbatim transcription. Data were analyzed systematically and comparatively using a thematic approach to explore the depth of opinions and understandings of oral health and disability. Participants shared the acceptance of some oral impairment and disability as an alternative view of a 'healthy' mouth as they balanced gains and losses, adjusted expectations, and sought social support. Participants discussed that an edentulous mouth might not always be disruptive to daily functioning for all. As a result, a full set of new dentures may not always be the ultimate goal.

Ethics, genetics and dynamics: an emerging systematic approach to radiation protection of the environment

International Nuclear Information System (INIS)

Pentreath, R.J.

2004-01-01

There is now a general consensus of opinion that an explicit approach is necessary to demonstrate radiation protection of the environment, and that this approach needs to be developed in a systematic way. The framework that is emerging links ethical and moral issues (anthropocentric, biocentric, and ecocentric) to broad-based principles and objectives of environmental protection (sustainable development, maintaining biological diversity, and habitat protection) and then links these, in turn, to the needs of current environmental management practices, such as environmental exploitation, pollution control, and nature conservation. The relevance of this to radiation is that its effects (such as causing early mortality, morbidity, reduced reproductive success, as well as resulting in observable (scorable) cytogenetic damage) are those that may have a bearing on these same environmental management practices. The devise that would appear to be most useful to bridge the gap between our disparate data on radiation effects and the needs of environmental management, is that of adding to the concept of Reference Man in the shape of a small set of Reference Animals and Plants. This approach has now been adopted by the ICRP, adding new dynamics--the motive forces, both moral and physical--to the subject. The way is now clear for rapid progress to be made on a number of fronts

Sound reduction of air compressors using a systematic approach

Science.gov (United States)

Moylan, Justin Tharp

The noise emitted by portable electric air compressors can often be a nuisance or potentially hazardous to the operator or others nearby. Therefore, reducing the noise of these air compressors is desired. This research focuses on compressors with a reciprocating piston design as this is the most common type of pump design for portable compressors. An experimental setup was developed to measure the sound and vibration of the air compressors, including testing inside a semi-anechoic chamber. The design of a quiet air compressor was performed in four stages: 1) Teardown and benchmarking of air compressors, 2) Identification and isolation of noise sources, 3) Development of individual means to quiet noise sources, 4) Selection and testing of integrated solutions. The systematic approach and results for each of these stages will be discussed. Two redesigned solutions were developed and measured to be approximately 65% quieter than the previous unmodified compressor. An additional analysis was performed on the solutions selected by the participants involved in the selection process. This analysis involved determining which of the design criteria each participant considered most important when selecting solutions. The results from each participant were then compared to their educational background and experience and correlations were identified. The correlations discovered suggest that educational background and experience may be key determinants for the preference models developed.

A systematic approach to developing a global surgery elective.

Science.gov (United States)

Hoehn, Richard S; Davis, Bradley R; Huber, Nathan L; Edwards, Michael J; Lungu, Douglas; Logan, Jocelyn M

2015-01-01

Interest in global health has been increasing for years among American residents and medical students. Many residency programs have developed global health tracks or electives in response to this need. Our goal was to create a global surgery elective based on a synergistic partnership between our institution and a hospital in the developing world. We created a business plan and 1-year schedule for researching potential sites and completing a pilot rotation at our selected hospital. We administered a survey to general surgery residents at the University of Cincinnati and visited medical facilities in Sierra Leone, Cameroon, and Malawi. The survey was given to all general surgery residents. A resident and a faculty member executed the fact-finding trip as well as the pilot rotation. Our general surgery residents view an international elective as integral to residency training and would participate in such an elective. After investigating 6 hospitals in sub-Saharan Africa, we conducted a pilot rotation at our selected hospital and gained the necessary information to organize a curriculum. We will begin sending senior residents for 8-week rotations in the coming academic year. By systematically approaching the process of creating a global surgery elective, we were able to gain considerable insight into choosing a location and organizing the elective. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The Benefits of Active Video Games for Educational and Physical Activity Approaches: A Systematic Review

Directory of Open Access Journals (Sweden)

Carlos Merino-Campos

2016-07-01

Full Text Available This article sets out to conduct a systematic review of the current literature on active video games as potential educational tools for physical education or physical activity. To begin with, research on active video games for educational and physical purposes has been examined with the purpose of verifying improvement of attitudes, intellectual skills, knowledge, motor skills and physical properties associated with physical activity and physical education. A second aim will be to determine the effectiveness of active video games compared with traditional approaches to physical activity. From this perspective, a systematic literature search from relevant international databases was conducted from January to July 2015 in order to find papers published in journals or conference proceedings from January 2010 onwards. Then, 2648 references were identified in database searches and 100 of these papers met the inclusion criteria. Two main conclusions are to be drawn from this research. Firstly, controlled studies demonstrate that active video games increase capacities in relation to physical activity and education. Secondly, Research also shows that physical activity interventions designed and measured using behavioural theories are more likely to be successful in comparison with traditional exercise activities.

A primer on systematic reviews in toxicology.

Science.gov (United States)

Hoffmann, Sebastian; de Vries, Rob B M; Stephens, Martin L; Beck, Nancy B; Dirven, Hubert A A M; Fowle, John R; Goodman, Julie E; Hartung, Thomas; Kimber, Ian; Lalu, Manoj M; Thayer, Kristina; Whaley, Paul; Wikoff, Daniele; Tsaioun, Katya

2017-07-01

Systematic reviews, pioneered in the clinical field, provide a transparent, methodologically rigorous and reproducible means of summarizing the available evidence on a precisely framed research question. Having matured to a well-established approach in many research fields, systematic reviews are receiving increasing attention as a potential tool for answering toxicological questions. In the larger framework of evidence-based toxicology, the advantages and obstacles of, as well as the approaches for, adapting and adopting systematic reviews to toxicology are still being explored. To provide the toxicology community with a starting point for conducting or understanding systematic reviews, we herein summarized available guidance documents from various fields of application. We have elaborated on the systematic review process by breaking it down into ten steps, starting with planning the project, framing the question, and writing and publishing the protocol, and concluding with interpretation and reporting. In addition, we have identified the specific methodological challenges of toxicological questions and have summarized how these can be addressed. Ultimately, this primer is intended to stimulate scientific discussions of the identified issues to fuel the development of toxicology-specific methodology and to encourage the application of systematic review methodology to toxicological issues.

Effectiveness of social work intervention with a systematic approach to improve general health in opioid addicts in addiction treatment centers.

Science.gov (United States)

Raheb, Ghoncheh; Khaleghi, Esmat; Moghanibashi-Mansourieh, Amir; Farhoudian, Ali; Teymouri, Robab

2016-01-01

This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. This is an experimental plan (pretest to posttest with a control group); the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30) and control (30) groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. A covariance analysis test and independent and dependent t -test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients' self-understanding and self-recognition, and enhancing social functioning.

The data base management system alternative for computing in the human services.

Science.gov (United States)

Sircar, S; Schkade, L L; Schoech, D

1983-01-01

The traditional incremental approach to computerization presents substantial problems as systems develop and grow. The Data Base Management System approach to computerization was developed to overcome the problems resulting from implementing computer applications one at a time. The authors describe the applications approach and the alternative Data Base Management System (DBMS) approach through their developmental history, discuss the technology of DBMS components, and consider the implications of choosing the DBMS alternative. Human service managers need an understanding of the DBMS alternative and its applicability to their agency data processing needs. The basis for a conscious selection of computing alternatives is outlined.

[Uniqueness seeking behavior as a self-verification: an alternative approach to the study of uniqueness].

Science.gov (United States)

Yamaoka, S

1995-06-01

Uniqueness theory explains that extremely high perceived similarity between self and others evokes negative emotional reactions and causes uniqueness seeking behavior. However, the theory conceptualizes similarity so ambiguously that it appears to suffer from low predictive validity. The purpose of the current article is to propose an alternative explanation of uniqueness seeking behavior. It posits that perceived uniqueness deprivation is a threat to self-concepts, and therefore causes self-verification behavior. Two levels of self verification are conceived: one based on personal categorization and the other on social categorization. The present approach regards uniqueness seeking behavior as the personal-level self verification. To test these propositions, a 2 (very high or moderate similarity information) x 2 (with or without outgroup information) x 2 (high or low need for uniqueness) between-subject factorial-design experiment was conducted with 95 university students. Results supported the self-verification approach, and were discussed in terms of effects of uniqueness deprivation, levels of self-categorization, and individual differences in need for uniqueness.

Differential diagnosis of nongap metabolic acidosis: value of a systematic approach.

Science.gov (United States)

Kraut, Jeffrey A; Madias, Nicolaos E

2012-04-01

Nongap metabolic acidosis is a common form of both acute and chronic metabolic acidosis. Because derangements in renal acid-base regulation are a common cause of nongap metabolic acidosis, studies to evaluate renal acidification often serve as the mainstay of differential diagnosis. However, in many cases, information obtained from the history and physical examination, evaluation of the electrolyte pattern (to determine if a nongap acidosis alone or a combined nongap and high anion gap metabolic acidosis is present), and examination of the serum potassium concentration (to characterize the disorder as hyperkalemic or hypokalemic in nature) is sufficient to make a presumptive diagnosis without more sophisticated studies. If this information proves insufficient, indirect estimates or direct measurement of urinary NH(4)(+) concentration, measurement of urine pH, and assessment of urinary HCO(3)(-) excretion can help in establishing the diagnosis. This review summarizes current information concerning the pathophysiology of this electrolyte pattern and the value and limitations of all of the diagnostic studies available. It also provides a systematic and cost-effective approach to the differential diagnosis of nongap metabolic acidosis.

The Influence of Social and Environmental Labels on Purchasing: An Information and Systematic-heuristic Processing Approach

Directory of Open Access Journals (Sweden)

Raquel Redondo Palomo

2015-07-01

Full Text Available This paper aims at exploring how social and environmental (SE labels influence purchasing. By drawing on the information processing and the systematic-heuristic models, this study tests the process followed by consumers when purchasing SE labeled-products. Information was gathered through a structured questionnaire in personal interviews with 400 consumers responsible for household shopping of Fast-moving Consumer Goods (FMCG, who were randomly approached at shopping malls in four areas of Madrid, Spain. They were asked about recognition, knowledge, credibility, perceived utility and purchases on 12 different labels; the influence of these variables on purchase is modeled and tested by path analysis. This study suggests that a systematic-heuristic information processing occurs when consumers buy SE-labeled FMCG products, as the purchase of this type of goods depends on the recognition of a label, knowledge of the issue/issuer, as well as the credibility and the perceived utility of SE labels. Motivation for being informed influences the process, being an antecedent of awareness, comprehension and perceived utility. This model shows a dual processing mode: systematic and heuristic, where the lack of cognitive capacity could explain why these two processing modes co-occur. This paper adds value to existing literature on SE labels and consumption by applying the information processing model, which has not been used before in the field of responsible consumption, in addition to open a promising avenue for research, by offering complementary theories to the existing ones, based on attitudes.

Systematic Applications of Metabolomics in Metabolic Engineering

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Robert A. Dromms

2012-12-01

Full Text Available The goals of metabolic engineering are well-served by the biological information provided by metabolomics: information on how the cell is currently using its biochemical resources is perhaps one of the best ways to inform strategies to engineer a cell to produce a target compound. Using the analysis of extracellular or intracellular levels of the target compound (or a few closely related molecules to drive metabolic engineering is quite common. However, there is surprisingly little systematic use of metabolomics datasets, which simultaneously measure hundreds of metabolites rather than just a few, for that same purpose. Here, we review the most common systematic approaches to integrating metabolite data with metabolic engineering, with emphasis on existing efforts to use whole-metabolome datasets. We then review some of the most common approaches for computational modeling of cell-wide metabolism, including constraint-based models, and discuss current computational approaches that explicitly use metabolomics data. We conclude with discussion of the broader potential of computational approaches that systematically use metabolomics data to drive metabolic engineering.

Pheromone based alternative route planning

Directory of Open Access Journals (Sweden)

Liangbing Feng

2016-08-01

Full Text Available In this work, we propose an improved alternative route calculation based on alternative figures, which is suitable for practical environments. The improvement is based on the fact that the main traffic route is the road network skeleton in a city. Our approach using nodes may generate a higher possibility of overlapping. We employ a bidirectional Dijkstra algorithm to search the route. To measure the quality of an Alternative Figures (AG, three quotas are proposed. The experiment results indicate that the improved algorithm proposed in this paper is more effective than others.

Alternative treatments for adults with attention-deficit hyperactivity disorder (ADHD).

Science.gov (United States)

Arnold, L E

2001-06-01

A previous review of alternative treatments (Tx) of ADHD--those other than psychoactive medication and behavioral/psychosocial Tx--was supplemented with an additional literature search focused on adults with ADHD. Twenty-four alternative Tx were identified, ranging in scientific documentation from discrediting controlled studies through mere hypotheses to positive controlled double-blind clinical trials. Many of them are applicable only to a specific subgroup. Although oligoantigenic (few-foods) diets have convincing double-blind evidence of efficacy for a properly selected subgroup of children, they do not appear promising for adults. Enzyme-potentiated desensitization, relaxation/EMG biofeedback, and deleading also have controlled evidence of efficacy. Iron supplementation, magnesium supplementation, Chinese herbals, EEG biofeedback, massage, meditation, mirror feedback, channel-specific perceptual training, and vestibular stimulation all have promising prospective pilot data, many of these tests reasonably controlled. Single-vitamin megadosage has some intriguing pilot trial data. Zinc supplementation is hypothetically supported by systematic case-control data, but no systematic clinical trial. Laser acupuncture has promising unpublished pilot data and may be more applicable to adults than children. Essential fatty acid supplementation has promising systematic case-control data, but clinical trials are equivocal. RDA vitamin supplementation, non-Chinese herbals, homeopathic remedies, and antifungal therapy have no systematic data in ADHD. Megadose multivitamin combinations are probably ineffective for most patients and are possibly dangerous. Simple sugar restriction seems ineffective. Amino acid supplementation is mildly effective in the short term, but not beyond 2-3 months. Thyroid treatment is effective in the presence of documented thyroid abnormality. Some alternative Tx of ADHD are effective or probably effective, but mainly for certain patients. In some

A systematic approach for introducing innovative product design in courses with engineering and nonengineering students.

Science.gov (United States)

Patterson, P E

2007-01-01

In our new global economy, biomedical product development teams need to be even more innovative in an environment constrained by fewer resources with less time from concept to market. Teams are often comprised of individuals spread around the world. To simulate this setting, we revised an existing course to incorporate teams of on-campus and distance students, with each team including both engineers and other specialties. Through interactive lectures and projects, we presented a systematic approach to innovation that should be useful to engineers and non-engineers alike. Students found the course challenging and exciting, displaying an improved ability to work in distributed teams and in developing innovative design solutions.

Alternative approaches to vertebrate ecotoxicity tests in the 21st century: A review of developments over the last 2 decades and current status.

Science.gov (United States)

Lillicrap, Adam; Belanger, Scott; Burden, Natalie; Pasquier, David Du; Embry, Michelle R; Halder, Marlies; Lampi, Mark A; Lee, Lucy; Norberg-King, Teresa; Rattner, Barnett A; Schirmer, Kristin; Thomas, Paul

2016-11-01

The need for alternative approaches to the use of vertebrate animals for hazard assessment of chemicals and pollutants has become of increasing importance. It is now the first consideration when initiating a vertebrate ecotoxicity test, to ensure that unnecessary use of vertebrate organisms is minimized wherever possible. For some regulatory purposes, the use of vertebrate organisms for environmental risk assessments has been banned; in other situations, the number of organisms tested has been dramatically reduced or the severity of the procedure refined. However, there is still a long way to go to achieve a complete replacement of vertebrate organisms to generate environmental hazard data. The development of animal alternatives is based not just on ethical considerations but also on reducing the cost of performing vertebrate ecotoxicity tests and in some cases on providing better information aimed at improving environmental risk assessments. The present Focus article provides an overview of the considerable advances that have been made toward alternative approaches for ecotoxicity assessments over the last few decades. Environ Toxicol Chem 2016;35:2637-2646. © 2016 SETAC. © 2016 SETAC.

External Validity and Model Validity: A Conceptual Approach for Systematic Review Methodology

Directory of Open Access Journals (Sweden)

Raheleh Khorsan

2014-01-01

Full Text Available Background. Evidence rankings do not consider equally internal (IV, external (EV, and model validity (MV for clinical studies including complementary and alternative medicine/integrative health care (CAM/IHC research. This paper describe this model and offers an EV assessment tool (EVAT© for weighing studies according to EV and MV in addition to IV. Methods. An abbreviated systematic review methodology was employed to search, assemble, and evaluate the literature that has been published on EV/MV criteria. Standard databases were searched for keywords relating to EV, MV, and bias-scoring from inception to Jan 2013. Tools identified and concepts described were pooled to assemble a robust tool for evaluating these quality criteria. Results. This study assembled a streamlined, objective tool to incorporate for the evaluation of quality of EV/MV research that is more sensitive to CAM/IHC research. Conclusion. Improved reporting on EV can help produce and provide information that will help guide policy makers, public health researchers, and other scientists in their selection, development, and improvement in their research-tested intervention. Overall, clinical studies with high EV have the potential to provide the most useful information about “real-world” consequences of health interventions. It is hoped that this novel tool which considers IV, EV, and MV on equal footing will better guide clinical decision making.

From disaster to development: a systematic review of community-driven humanitarian logistics.

Science.gov (United States)

Bealt, Jennifer; Mansouri, S Afshin

2018-01-01

A plethora of untapped resources exist within disaster-affected communities that can be used to address relief and development concerns. A systematic review of the literature relating to community participation in humanitarian logistics activities revealed that communities are able to form ad hoc networks that have the ability to meet a wide range of disaster management needs. These structures, characterised as Collaborative Aid Networks (CANs), have demonstrated efficient logistical capabilities exclusive of humanitarian organisations. This study proposes that CANs, as a result of their unique characteristics, present alternatives to established humanitarian approaches to logistics, while also mitigating the challenges commonly faced by traditional humanitarian organisations. Furthermore, CANs offer a more holistic, long-term approach to disaster management, owing to their impact on development through their involvement in humanitarian logistics. This research provides the foundation for further theoretical analysis of effective and efficient disaster management, and details opportunities for policy and practice. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

The (in)accuracy of travel demand forecasts in the case of no-build alternatives

DEFF Research Database (Denmark)

Nicolaisen, Morten Skou; Næss, Petter

-build alternatives, in order to assess the impact of doing something rather than doing nothing. Previous research on the accuracy of demand forecasts has focused exclusively on the build alternatives, and revealed inaccuracies in the form of large imprecisions as well as systematic biases. However, little...... of dealing with congestion problems, which might prove more sustainable and resilient in the long run....

Towards a Life Cycle Based Chemical Alternative Assessment (LCAA)

DEFF Research Database (Denmark)

Jolliet, O.; Huang, L.; Overcash, Michael

2017-01-01

approach combines the following elements: a) The manufacturing phase chemical inventory is based on the environmental genome of industrial products database, ensuring mass and energy balance, b) near-field exposure to consumer products during the use phase is determined based on the mass of chemical......There is a need for an operational quantitative screening-level assessment of alternatives, that is life-cycle based and able to serve both Life cycle Assessment (LCA and chemical alternatives assessment (CAA). This presentation therefore aims to develop and illustrate a new approach called “Life...... Cycle Based Chemical Alternative Assessment (LCAA)” that will quantify exposure and life cycle impacts consistently and efficiently over the main life cycle stages. The new LCAA approach is illustrated though a proof-of-concept case study of alternative plasticizers in vinyl flooring. The proposed LCAA...

An alternative clinical approach to achieve greater anterior than posterior maxillary expansion in cleft lip and palate patients.

Science.gov (United States)

Oliveira, Dauro Douglas; Bartolomeo, Flávia Uchôa Costa; Cardinal, Lucas; Figueiredo, Daniel Santos Fonseca; Palomo, Juan Martin; Andrade, Ildeu

2014-11-01

Cleft lip and palate patients commonly present maxillary constriction, particularly in the anterior region. The aim of this case report was to describe an alternative clinical approach that used a smaller Hyrax screw unconventionally positioned to achieve greater anterior than posterior expansion in patients with complete unilateral cleft lip and palate. The idea presented here is to take advantage of a reduced dimension screw to position it anteriorly. When only anterior expansion was needed (patient 1), the appliance was soldered to the first premolar bands and associated to a transpalatal arch cemented to the first molars. However, when overall expansion was required (patient 2), the screw was positioned anteriorly, but soldered to the first molar bands. Intercanine, premolar, and first molar widths were measured on dental casts with a digital caliper. Pre-expansion and postexpansion radiographs and tomographies were also evaluated. A significant anterior expansion and no intermolar width increase were registered in the first patient. Although patient 2 also presented a greater anterior than posterior expansion, a noteworthy expansion occurred at the molar region. The alternative approach to expand the maxilla in cleft patients reported here caused greater anterior than posterior expansion when the Mini-Hyrax was associated to a transpalatal arch, and its reduced dimension also minimized discomfort and facilitated hygiene.

An Alternative to Ability Grouping

Science.gov (United States)

Tomlinson, Carol Ann

2006-01-01

Ability grouping is a common approach to dealing with student variance in learning. In general, findings suggest that such an approach to dealing with student differences is disadvantageous to students who struggle in school and advantageous to advanced learners. The concept of differentiation suggests that there is another alternative to…

Integrating Volcanic Hazard Data in a Systematic Approach to Develop Volcanic Hazard Maps in the Lesser Antilles

Directory of Open Access Journals (Sweden)

Jan M. Lindsay

2018-04-01

Full Text Available We report on the process of generating the first suite of integrated volcanic hazard zonation maps for the islands of Dominica, Grenada (including Kick ‘em Jenny and Ronde/Caille, Nevis, Saba, St. Eustatius, St. Kitts, Saint Lucia, and St Vincent in the Lesser Antilles. We developed a systematic approach that accommodated the range in prior knowledge of the volcanoes in the region. A first-order hazard assessment for each island was used to develop one or more scenario(s of likely future activity, for which scenario-based hazard maps were generated. For the most-likely scenario on each island we also produced a poster-sized integrated volcanic hazard zonation map, which combined the individual hazardous phenomena depicted in the scenario-based hazard maps into integrated hazard zones. We document the philosophy behind the generation of this suite of maps, and the method by which hazard information was combined to create integrated hazard zonation maps, and illustrate our approach through a case study of St. Vincent. We also outline some of the challenges we faced using this approach, and the lessons we have learned by observing how stakeholders have interacted with the maps over the past ~10 years. Based on our experience, we recommend that future map makers involve stakeholders in the entire map generation process, especially when making design choices such as type of base map, use of colour and gradational boundaries, and indeed what to depict on the map. We also recommend careful consideration of how to evaluate and depict offshore hazard of island volcanoes, and recommend computer-assisted modelling of all phenomena to generate more realistic hazard footprints. Finally, although our systematic approach to integrating individual hazard data into zones generally worked well, we suggest that a better approach might be to treat the integration of hazards on a case-by-case basis to ensure the final product meets map users' needs. We hope that

Systematic Approach to Training for System Engineers in Nuclear Power Plants

Energy Technology Data Exchange (ETDEWEB)

Kwak, Jeong-keun [Korea Hydro and Nuclear Power Co., Ulsan (Korea, Republic of)

2015-10-15

In my paper, comprehensive preparations, tangible applications, and final establishments of training for system engineers are described using practical materials in KHNP. The purpose of this paper is to formulate SAT based training in KHNP, especially for system engineers. Hence, to achieve this goal, over one year study was performed considering voluminous materials and working experiences. Through the process, SAT based training package for system engineers was finished, in the end. In terms of training in NPPs, SAT methodology is the unwavering trend in South Korea since NPPs export to UAE. Therefore, materialization of SAT based training for system engineers from the origin of SAT to the finalization of SAT should not be overlooked. A variety of accident preventive approaches have been adopted since the first commercial NPP operation in Calder Hall, United Kingdom. Among diverse event preventive ways, training has played an important role for the improvement of NPPs reliability and safety. This is reason why nuclear industry in every country has established and maintained own training institutes and methods. Since the Three Mile Island (TMI) accident, United States Nuclear Regulatory Commission (USNRC) recommended many betterment plans to US nuclear industry for the elevation of NPPs safety. In the suggested considerations, systematic approach to training, so called SAT appeared in the world. Basically, SAT is composed of five stages, what is called ADDIE. Hence, through ADDIE process, holistic and trustworthy training could be realized in the actual NPPs operation and maintenance. For this reason, SAT is the representative training methodology in the US nuclear business.

Systematic Approach to Training for System Engineers in Nuclear Power Plants

International Nuclear Information System (INIS)

Kwak, Jeong-keun

2015-01-01

In my paper, comprehensive preparations, tangible applications, and final establishments of training for system engineers are described using practical materials in KHNP. The purpose of this paper is to formulate SAT based training in KHNP, especially for system engineers. Hence, to achieve this goal, over one year study was performed considering voluminous materials and working experiences. Through the process, SAT based training package for system engineers was finished, in the end. In terms of training in NPPs, SAT methodology is the unwavering trend in South Korea since NPPs export to UAE. Therefore, materialization of SAT based training for system engineers from the origin of SAT to the finalization of SAT should not be overlooked. A variety of accident preventive approaches have been adopted since the first commercial NPP operation in Calder Hall, United Kingdom. Among diverse event preventive ways, training has played an important role for the improvement of NPPs reliability and safety. This is reason why nuclear industry in every country has established and maintained own training institutes and methods. Since the Three Mile Island (TMI) accident, United States Nuclear Regulatory Commission (USNRC) recommended many betterment plans to US nuclear industry for the elevation of NPPs safety. In the suggested considerations, systematic approach to training, so called SAT appeared in the world. Basically, SAT is composed of five stages, what is called ADDIE. Hence, through ADDIE process, holistic and trustworthy training could be realized in the actual NPPs operation and maintenance. For this reason, SAT is the representative training methodology in the US nuclear business

Targeting Medication Non-Adherence Behavior in Selected Autoimmune Diseases: A Systematic Approach to Digital Health Program Development.

Directory of Open Access Journals (Sweden)

Trevor van Mierlo

discovered. Over one third of articles identified the following risk factors as common contributors to medication non-adherence (percent of studies reporting: patients not understanding treatment (44%, side effects (41%, age (37%, dose regimen (33%, and perceived medication ineffectiveness (33%. An unanticipated finding that emerged was the need for risk stratification tools (81% with patient-centric approaches (67%.This study systematically identifies and categorizes medication non-adherence risk factors in select autoimmune diseases. Findings indicate that patients understanding of their disease and the role of medication are paramount. An unexpected finding was that the majority of research articles called for the creation of tailored, patient-centric interventions that dispel personal misconceptions about disease, pharmacotherapy, and how the body responds to treatment. To our knowledge, these interventions do not yet exist in digital format. Rather than adopting a systems level approach, digital health programs should focus on cohorts with heterogeneous needs, and develop tailored interventions based on individual non-adherence patterns.

Alternative approach to nuclear data representation

International Nuclear Information System (INIS)

Pruet, J.; Brown, D.; Beck, B.; McNabb, D.P.

2006-01-01

This paper considers an approach for representing nuclear data that is qualitatively different from the approach currently adopted by the nuclear science community. Specifically, we examine a representation in which complicated data is described through collections of distinct and self-contained simple data structures. This structure-based representation is compared with the ENDF and ENDL formats, which can be roughly characterized as dictionary-based representations. A pilot data representation for replacing the format currently used at LLNL is presented. Examples are given as is a discussion of promises and shortcomings associated with moving from traditional dictionary-based formats to a structure-rich or class-like representation

A multicriteria model for ranking of improvement approaches in construction companies based on the PROMETHÉE II method

Directory of Open Access Journals (Sweden)

Renata Maciel de Melo

2015-03-01

Full Text Available The quality of the construction production process may be improved using several different methods such as Lean Construction, ISO 9001, ISO 14001 or ISO 18001. Construction companies need a preliminary study and systematic implementation of changes to become more competitive and efficient. This paper presents a multicriteria decision model for the selection and ranking of such alternatives for improvement approaches regarding the aspects of quality, sustainability and safety, based on the PROMETHEE II method. The adoption of this model provides more confidence and visibility for decision makers. One of the differentiators of this model is the use of a fragmented set of improvement alternatives. These alternatives were combined with some restrictions to create a global set of alternatives. An application to three scenarios, considering realistic data, was developed. The results of the application show that the model should be incorporated into the strategic planning process of organizations.

Complementary and Alternative Medicine: The Mozart Effect on Childhood Epilepsy--A Systematic Review

Science.gov (United States)

Brackney, Dana E.; Brooks, Jessica L.

2018-01-01

This systematic review examines the effectiveness of Mozart's music in decreasing seizures in children with epilepsy (Mozart Effect) using the Johns Hopkins Nursing Evidence-Based Practice rating scale©. A search for articles with "Mozart Effect," "child*," and "epilepsy" was conducted in CINAHL Complete, Science…

[The grounded theory as a methodological alternative for nursing research].

Science.gov (United States)

dos Santos, Sérgio Ribeiro; da Nóbrega, Maria Miriam

2002-01-01

This study presents a method of interpretative and systematic research with appliance to the development of studies in nursing called "the grounded theory", whose theoretical support is the symbolic interactionism. The purpose of the paper is to describe the grounded theory as an alternative methodology for the construction of knowledge in nursing. The study highlights four topics: the basic principle, the basic concepts, the trajectory of the method and the process of analysis of the data. We conclude that the systematization of data and its interpretation, based on social actors' experience, constitute strong subsidies to generate theories through this research tool.

Alternative Energy Systems

Energy Technology Data Exchange (ETDEWEB)

West, M.; Duckers, L.; Lockett, P.; Loughridge, B.; Peatfield, T.; White, P.

1984-01-01

The Coventry (Lanchester) Polytechnic Wave Energy Group has been involved in the United Kingdom wave energy research programme since its inception in 1975. Whilst the work of the group is mainly concerned with wave energy, and currently is directed towards the design of a wave energy device tailored to the needs of isolated/island communities, it has some involvement with other aspects of the alternatives. This conference, dealing with alternative energy systems and their electrical integration and utilisation was engendered by the general interest which the Polytechnic group members have in the alternatives and their use. The scope for electrical integration and utilisation is very broad. Energy for family groups may be provided in a relatively unsophisticated way which is acceptable to them. Small population centres, for example island communities relying upon diesel equipment, can reap the benefits of the alternatives through their ability to accept novel integration schemes and a flexible approach to the use of the energy available. Consumers already enjoying the benefits of a 'firm' electricity grid supply can use energy from a variety of alternative systems, via the grid, without having to modify their energy consumption habits. In addition to the domestic and industrial applications and coastal possibilities, specialist applications in isolated environments have also emerged. The Proceedings detail practical, technical and economic aspects of the alternatives and their electrical integration and utilisation.

Essential oils: an alternative approach to management of powdery mildew diseases

Directory of Open Access Journals (Sweden)

Elena STURCHIO

2015-01-01

Full Text Available In recent years there has been growing interest in the application of plant-derived substances in agriculture as alternatives to the use of pesticides, in order to obtain healthy crops and more environmentally sustainable crop production systems. The properties of some essential oils as natural fungicides were evaluated, to promote their use in alternative agriculture. Potentially detrimental effects caused by essential oil residues in soil were also assessed by mutagenicity assays to avoid possible adverse effects related to the use of these materials. Trials in a controlled environment were set up, using ‘Romanesco’ zucchini treated with essential oils, either exclusively or alternated with a synthetic fungicide. The treatments were applied when natural infection by Podosphaera xanthii appeared on test plants, and powdery mildew incidence and severity were assessed after six weeks. Preliminary results indicated that the alternation of natural materials with effective synthetic fungicide maintained effective disease control, and may also assist with management of pesticide resistance in P. xanthii. No relevant mutagenic effects of essential oil residues in soil were revealed, although an appropriate formulation useful under field conditions is required for effective application.

Nucleic Acid Aptamers Against Biotoxins: A New Paradigm Toward the Treatment and Diagnostic Approach

DEFF Research Database (Denmark)

Lauridsen, Lasse Holm; Veedu, Rakesh N.

2012-01-01

Nucleic acid aptamers are short single-stranded DNA or RNA oligonucleotides that can bind to their targets with very high affinity and specificity, and are generally selected by a process referred to as systematic evolution of ligands by exponential enrichment. Conventional antibody-based therape......Nucleic acid aptamers are short single-stranded DNA or RNA oligonucleotides that can bind to their targets with very high affinity and specificity, and are generally selected by a process referred to as systematic evolution of ligands by exponential enrichment. Conventional antibody......-based therapeutic and diagnostic approach currently employed against biotoxins pose major limitations such as the requirement of a live animal for the in vivo enrichment of the antibody species, decreased stability, high production cost, and side effects. Aptamer technology is a viable alternative that can be used...

New Approaches to Airway Management in Tracheal Resections-A Systematic Review and Meta-analysis.

Science.gov (United States)

Schieren, Mark; Böhmer, Andreas; Dusse, Fabian; Koryllos, Aris; Wappler, Frank; Defosse, Jerome

2017-08-01

Although endotracheal intubation, surgical crossfield intubation, and jet ventilation are standard techniques for airway management in tracheal resections, there are also reports of new approaches, ranging from regional anesthesia to extracorporeal support. The objective was to outline the entire spectrum of new airway techniques. The literature databases PubMed/Medline and the Cochrane Library were searched systematically for prospective and retrospective trials as well as case reports on tracheal resections. No restrictions applied to hospital types or settings. Adult patients undergoing surgical resections of noncongenital tracheal stenoses with end-to-end anastomoses. Airway management techniques were divided into conventional and new approaches and analyzed regarding their potential risks and benefits. A total of 59 publications (n = 797 patients) were included. The majority of publications (71.2%) describe conventional airway techniques. Endotracheal tube placement after induction of general anesthesia and surgical crossfield intubation after incision of the trachea were used most frequently without major complications. A total of 7 new approaches were identified, including 4 different regional anesthetic techniques (25 cases), supraglottic airways (4 cases), and new forms of extracorporeal support (25 cases). Overall failure rates of new techniques were low (1.8%). Details on patient selection and procedural specifics are provided. New approaches have several theoretical benefits, yet further research is required to establish criteria for patient selection and evaluate procedural safety. Given the low level of evidence, it currently is impossible to compare methods of airway management regarding outcome-related risks and benefits. Copyright © 2017 Elsevier Inc. All rights reserved.

Machine learning approaches to analysing textual injury surveillance data: a systematic review.

Science.gov (United States)

Vallmuur, Kirsten

2015-06-01

To synthesise recent research on the use of machine learning approaches to mining textual injury surveillance data. Systematic review. The electronic databases which were searched included PubMed, Cinahl, Medline, Google Scholar, and Proquest. The bibliography of all relevant articles was examined and associated articles were identified using a snowballing technique. For inclusion, articles were required to meet the following criteria: (a) used a health-related database, (b) focused on injury-related cases, AND used machine learning approaches to analyse textual data. The papers identified through the search were screened resulting in 16 papers selected for review. Articles were reviewed to describe the databases and methodology used, the strength and limitations of different techniques, and quality assurance approaches used. Due to heterogeneity between studies meta-analysis was not performed. Occupational injuries were the focus of half of the machine learning studies and the most common methods described were Bayesian probability or Bayesian network based methods to either predict injury categories or extract common injury scenarios. Models were evaluated through either comparison with gold standard data or content expert evaluation or statistical measures of quality. Machine learning was found to provide high precision and accuracy when predicting a small number of categories, was valuable for visualisation of injury patterns and prediction of future outcomes. However, difficulties related to generalizability, source data quality, complexity of models and integration of content and technical knowledge were discussed. The use of narrative text for injury surveillance has grown in popularity, complexity and quality over recent years. With advances in data mining techniques, increased capacity for analysis of large databases, and involvement of computer scientists in the injury prevention field, along with more comprehensive use and description of quality

Defined PEG smears as an alternative approach to enhance the search for crystallization conditions and crystal-quality improvement in reduced screens

Energy Technology Data Exchange (ETDEWEB)

Chaikuad, Apirat, E-mail: apirat.chaikuad@sgc.ox.ac.uk [University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford OX3 7DQ (United Kingdom); Knapp, Stefan [University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford OX3 7DQ (United Kingdom); Johann Wolfgang Goethe-University, Building N240 Room 3.03, Max-von-Laue-Strasse 9, 60438 Frankfurt am Main (Germany); Delft, Frank von, E-mail: apirat.chaikuad@sgc.ox.ac.uk [University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford OX3 7DQ (United Kingdom)

2015-07-28

An alternative strategy for PEG sampling is suggested through the use of four newly defined PEG smears to enhance chemical space in reduced screens with a benefit towards protein crystallization. The quest for an optimal limited set of effective crystallization conditions remains a challenge in macromolecular crystallography, an issue that is complicated by the large number of chemicals which have been deemed to be suitable for promoting crystal growth. The lack of rational approaches towards the selection of successful chemical space and representative combinations has led to significant overlapping conditions, which are currently present in a multitude of commercially available crystallization screens. Here, an alternative approach to the sampling of widely used PEG precipitants is suggested through the use of PEG smears, which are mixtures of different PEGs with a requirement of either neutral or cooperatively positive effects of each component on crystal growth. Four newly defined smears were classified by molecular-weight groups and enabled the preservation of specific properties related to different polymer sizes. These smears not only allowed a wide coverage of properties of these polymers, but also reduced PEG variables, enabling greater sampling of other parameters such as buffers and additives. The efficiency of the smear-based screens was evaluated on more than 220 diverse recombinant human proteins, which overall revealed a good initial crystallization success rate of nearly 50%. In addition, in several cases successful crystallizations were only obtained using PEG smears, while various commercial screens failed to yield crystals. The defined smears therefore offer an alternative approach towards PEG sampling, which will benefit the design of crystallization screens sampling a wide chemical space of this key precipitant.

Patient-as-observer approach: an alternative method for hand hygiene auditing in an ambulatory care setting.

Science.gov (United States)

Le-Abuyen, Sheila; Ng, Jessica; Kim, Susie; De La Franier, Anne; Khan, Bibi; Mosley, Jane; Gardam, Michael

2014-04-01

A survey pilot asked patients to observe the hand hygiene compliance of their health care providers. Patients returned 75.1% of the survey cards distributed, and the overall hand hygiene compliance was 96.8%. Survey results and patient commentary were used to motivate hand hygiene compliance. The patient-as-observer approach appeared to be a viable alternative for hand hygiene auditing in an ambulatory care setting because it educated, engaged, and empowered patients to play a more active role in their own health care. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Mediating Policy-Relevant Evidence at Speed: Are Systematic Reviews of Systematic Reviews a Useful Approach?

Science.gov (United States)

Caird, Jenny; Sutcliffe, Katy; Kwan, Irene; Dickson, Kelly; Thomas, James

2015-01-01

When swift, accurate appraisal of evidence is required to inform policy concerning broad research questions, and budgetary constraints limit the employment of large research teams, researchers face a significant challenge which is sometimes met by reviewing existing systematic reviews. In this paper we highlight the challenges inherent in the…

Study-design selection criteria in systematic reviews of effectiveness of health systems interventions and reforms: A meta-review.

Science.gov (United States)

Rockers, Peter C; Feigl, Andrea B; Røttingen, John-Arne; Fretheim, Atle; de Ferranti, David; Lavis, John N; Melberg, Hans Olav; Bärnighausen, Till

2012-03-01

At present, there exists no widely agreed upon set of study-design selection criteria for systematic reviews of health systems research, except for those proposed by the Cochrane Collaboration's Effective Practice and Organisation of Care (EPOC) review group (which comprises randomized controlled trials, controlled clinical trials, controlled before-after studies, and interrupted time series). We conducted a meta-review of the study-design selection criteria used in systematic reviews available in the McMaster University's Health Systems Evidence or the EPOC database. Of 414 systematic reviews, 13% did not indicate any study-design selection criteria. Of the 359 studies that described such criteria, 50% limited their synthesis to controlled trials and 68% to some or all of the designs defined by the EPOC criteria. Seven out of eight reviews identified at least one controlled trial that was relevant for the review topic. Seven percent of the reviews included either no or only one relevant primary study. Our meta-review reveals reviewers' preferences for restricting synthesis to controlled experiments or study designs that comply with the EPOC criteria. We discuss the advantages and disadvantages of the current practices regarding study-design selection in systematic reviews of health systems research as well as alternative approaches. Copyright © 2012. Published by Elsevier Ireland Ltd.

Systematic Correlation Matrix Evaluation (SCoMaE) - a bottom-up, science-led approach to identifying indicators

Science.gov (United States)

Mengis, Nadine; Keller, David P.; Oschlies, Andreas

2018-01-01

This study introduces the Systematic Correlation Matrix Evaluation (SCoMaE) method, a bottom-up approach which combines expert judgment and statistical information to systematically select transparent, nonredundant indicators for a comprehensive assessment of the state of the Earth system. The methods consists of two basic steps: (1) the calculation of a correlation matrix among variables relevant for a given research question and (2) the systematic evaluation of the matrix, to identify clusters of variables with similar behavior and respective mutually independent indicators. Optional further analysis steps include (3) the interpretation of the identified clusters, enabling a learning effect from the selection of indicators, (4) testing the robustness of identified clusters with respect to changes in forcing or boundary conditions, (5) enabling a comparative assessment of varying scenarios by constructing and evaluating a common correlation matrix, and (6) the inclusion of expert judgment, for example, to prescribe indicators, to allow for considerations other than statistical consistency. The example application of the SCoMaE method to Earth system model output forced by different CO2 emission scenarios reveals the necessity of reevaluating indicators identified in a historical scenario simulation for an accurate assessment of an intermediate-high, as well as a business-as-usual, climate change scenario simulation. This necessity arises from changes in prevailing correlations in the Earth system under varying climate forcing. For a comparative assessment of the three climate change scenarios, we construct and evaluate a common correlation matrix, in which we identify robust correlations between variables across the three considered scenarios.

What if the number of nanotoxicity data is too small for developing predictive Nano-QSAR models? An alternative read-across based approach for filling data gaps.

Science.gov (United States)

Gajewicz, Agnieszka

2017-06-22

Over the past decade, computational nanotoxicology, in particular Quantitative Structure-Activity Relationship models (Nano-QSAR) that help in assessing the biological effects of nanomaterials, have received much attention. In effect, a solid basis for uncovering the relationships between the structure and property/activity of nanoparticles has been created. Nonetheless, six years after the first pioneering computational studies focusing on the investigation of nanotoxicity were commenced, these computational methods still suffer from many limitations. These are mainly related to the paucity of widely available, systematically varied, libraries of experimental data necessary for the development and validation of such models. This results in the still-low acceptance of these methods as valuable research tools for nanosafety and raises the query as to whether these methods could gain wide acceptance of regulatory bodies as alternatives for traditional in vitro methods. This study aimed to give an answer to the following question: How to remedy the paucity of experimental nanotoxicity data and thereby, overcome key roadblock that hinders the development of approaches for data-driven modeling of nanoparticle properties and toxicities? Here, a simple and transparent read-across algorithm for a pre-screening hazard assessment of nanomaterials that provides reasonably accurate results by making the best use of existing limited set of observations will be introduced.

Alternatives to antibiotics-a pipeline portfolio review.

Science.gov (United States)

Czaplewski, Lloyd; Bax, Richard; Clokie, Martha; Dawson, Mike; Fairhead, Heather; Fischetti, Vincent A; Foster, Simon; Gilmore, Brendan F; Hancock, Robert E W; Harper, David; Henderson, Ian R; Hilpert, Kai; Jones, Brian V; Kadioglu, Aras; Knowles, David; Ólafsdóttir, Sigríður; Payne, David; Projan, Steve; Shaunak, Sunil; Silverman, Jared; Thomas, Christopher M; Trust, Trevor J; Warn, Peter; Rex, John H

2016-02-01

Antibiotics have saved countless lives and enabled the development of modern medicine over the past 70 years. However, it is clear that the success of antibiotics might only have been temporary and we now expect a long-term and perhaps never-ending challenge to find new therapies to combat antibiotic-resistant bacteria. A broader approach to address bacterial infection is needed. In this Review, we discuss alternatives to antibiotics, which we defined as non-compound approaches (products other than classic antibacterial agents) that target bacteria or any approaches that target the host. The most advanced approaches are antibodies, probiotics, and vaccines in phase 2 and phase 3 trials. This first wave of alternatives to antibiotics will probably best serve as adjunctive or preventive therapies, which suggests that conventional antibiotics are still needed. Funding of more than £1·5 billion is needed over 10 years to test and develop these alternatives to antibiotics. Investment needs to be partnered with translational expertise and targeted to support the validation of these approaches in phase 2 trials, which would be a catalyst for active engagement and investment by the pharmaceutical and biotechnology industry. Only a sustained, concerted, and coordinated international effort will provide the solutions needed for the future. Copyright © 2016 Elsevier Ltd. All rights reserved.

Taking a case study approach to assessing alternative leadership models in health care.

Science.gov (United States)

Harris, Jonathan; Mayo, Paula

2018-06-14

Good leadership is essential to patient-centred care and staff satisfaction in the healthcare environment. All members of the healthcare team can be leaders and evidence-based theory should inform their leadership practice. This article uses a case study approach to critically evaluate leadership as exercised by a charge nurse and a student nurse in a clinical scenario. Ineffective leadership styles are identified and alternatives proposed; considerable attention is given to critiquing both 'heroic' and 'post-heroic' transformational leadership theories. The concept of power will also be discussed, as power and leadership are closely related, and the importance of empowering members of the healthcare team through altering organisational structure is emphasised. This article advocates leadership that encourages innovation, enhances patient-centred care, encourages excellence and has ethical integrity. Recommendations of appropriate models of leadership are provided, while existing gaps in the healthcare leadership literature are highlighted.

Systematic approach for the design of sustainable supply chains under quality uncertainty

International Nuclear Information System (INIS)

Medina-González, Sergio; Graells, Moisès; Guillén-Gosálbez, Gonzalo; Espuña, Antonio; Puigjaner, Luis

2017-01-01

Highlights: • This methodology allows taking profit of the uneven biomass quality in the management of energy supply chains. • The proposed strategy allows the solution selection considering multiple decision criteria. • The proposed strategy facilitates decision-making avoiding subjectivity in the solution selection. • The resulting base model is generic and the strategy is flexible enough to be implemented in other real cases. - Abstract: Sustainable processes have recently awaked an increasing interest in the process systems engineering literature. In industry, this kind of problems inevitably required a multi-objective analysis to evaluate the environmental impact in addition to the economic performance. Bio-based processes have the potential to enhance the sustainability level of the energy sector. Nevertheless, such processes very often show variable conditions and present an uncertain behavior. The approaches presented for solving multi-objective problems under uncertainty have neglected the potential effects of different quality streams on the overall system. Here, it is presented an alternative approach, based on a State Task Network formulation, capable of optimizing under uncertain conditions, considering multiple selection criteria and accounting for the material quality effect. The resulting set of Pareto solutions are then assessed using the Elimination and Choice Expressing Reality-IV method, which identify the ones showing better overall performance considering the uncertain parameters space.

Acupuncture and related therapies used as add-on or alternative to prokinetics for functional dyspepsia: overview of systematic reviews and network meta-analysis.

Science.gov (United States)

Ho, Robin S T; Chung, Vincent C H; Wong, Charlene H L; Wu, Justin C Y; Wong, Samuel Y S; Wu, Irene X Y

2017-09-04

Prokinetics for functional dyspepsia (FD) have relatively higher number needed to treat values. Acupuncture and related therapies could be used as add-on or alternative. An overview of systematic reviews (SRs) and network meta-analyses (NMA) were performed to evaluate the comparative effectiveness of different acupuncture and related therapies. We conducted a comprehensive literature search for SRs of randomized controlled trials (RCTs) in eight international and Chinese databases. Data from eligible RCTs were extracted for random effect pairwise meta-analyses. NMA was used to explore the most effective treatment among acupuncture and related therapies used alone or as add-on to prokinetics, compared to prokinetics alone. From five SRs, 22 RCTs assessing various acupuncture and related therapies were included. No serious adverse events were reported. Two pairwise meta-analyses showed manual acupuncture has marginally stronger effect in alleviating global FD symptoms, compared to domperidone or itopride. Results from NMA showed combination of manual acupuncture and clebopride has the highest probability in alleviating patient reported global FD symptom. Combination of manual acupuncture and clebopride has the highest probability of being the most effective treatment for FD symptoms. Patients who are contraindicated for prokinetics may use manual acupuncture or moxibustion as alternative. Future confirmatory comparative effectiveness trials should compare clebopride add-on manual acupuncture with domperidone add-on manual acupuncture and moxibustion.

ALTERNATIVE APPROACH IN THE TREATMENT OF A GINGIVAL CLEFT ASSOCIATED WITH LABIAL FRENULUM. A 3-YEAR FOLLOW-UP. (Case Report

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Kamen Kotsilkov

2015-07-01

Full Text Available INTRODUCTION: The term Gingival cleft refers to a fissure in the gingival tissues and is usually caused by traumatic oral hygiene, abnormal frenula, trauma from occlusion, orthodontic, or pierce related trauma. Gingival clefts are classified depending on the extent of the inclusion of the gingival thickness into red and white. The recommended treatment approach for the incomplete white clefts is the gingivectomy of the affected keratinized tissue followed by a coronally advanced flap for the root coveradge, while the complete white clefts are treated with a laterally moved, coronally advanced flap, or a free gingival graft procedure. OBJECTIVE: This report presents a case with a spontaneous healing of an incomplete gingival cleft associated with a maxillary labial frenulum after an alternative frenuloectomy approach. METHODS: M.G. (45 with a localized chronic periodontitis, an abnormal papillary maxillary frenulum and an incomplete white cleft on the marginal gingiva of the left central incisor. An alternative frenuloectomy approach combined with a free gingival graft was selected for the correction of the abnormal frenulum. RESULTS:On the sixth month after the surgical procedure an almost complete recovery of the gingival margin was observed.The result at the third year demonstrates a stable gingival margin with a complete tissue recovery. CONCLUSION: The applied combined surgical approach led to a complete gingival recovery of the incomplete white gingival cleft without the commonly used gingivectomy and CAF. Further research is recommended to clarify the adjunctive benefits of the FGG in patients with gingival clefts associated with abnormal frenula.

Polyketones as alternating copolymers of carbon monoxide

International Nuclear Information System (INIS)

Belov, Gennady P; Novikova, Elena V

2004-01-01

Characteristic features of the catalytic synthesis of alternating copolymers of carbon monoxide with various olefins, dienes, styrene and its derivatives are considered. The diversity of catalyst systems used for the copolymerisation of carbon monoxide is demonstrated and their influence on the structure and the molecular mass of the resulting copolymers is analysed. The data on the structure and physicochemical and mechanical properties of this new generation of functional copolymers are generalised and described systematically for the first time.

Selection Methodology Approach to Preferable and Alternative Sites for the First NPP Project in Yemen

Energy Technology Data Exchange (ETDEWEB)

Kassim, Moath [Kyunghe Univ., Yongin (Korea, Republic of); Kessel, David S. [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

2015-05-15

The purpose of this paper is to briefly present the methodology and results of the first siting study for the first nuclear power plant (NPP) in Yemen. In this study it has been demonstrated that there are suitable sites for specific unit/units power of 1000 MWt (about 300 MWe) nuclear power plant. To perform the site selection, a systematic selection method was developed. The method uses site-specific data gathered by literature review and expert judgement to identify the most important site selection criteria. A two-step site selection process was used. Candidate sites were chosen that meet a subset of the selection criteria that form the most important system constraints. These candidate sites were then evaluated against the full set of selection criteria using the Analytical Hierarchy Process Method (AHP). Candidate sites underwent a set of more specific siting criteria weighted by expert judgment to select preferable sites and alternatives using AHP method again. Expert Judgment method was used to rank and weight the importance of each criteria, then AHP method used to evaluate and weight the relation between criterion to criterion and between all criteria against the global weight. Then logical decision software was used to rank sites upon their weighting value.

Selection Methodology Approach to Preferable and Alternative Sites for the First NPP Project in Yemen

International Nuclear Information System (INIS)

Kassim, Moath; Kessel, David S.

2015-01-01

The purpose of this paper is to briefly present the methodology and results of the first siting study for the first nuclear power plant (NPP) in Yemen. In this study it has been demonstrated that there are suitable sites for specific unit/units power of 1000 MWt (about 300 MWe) nuclear power plant. To perform the site selection, a systematic selection method was developed. The method uses site-specific data gathered by literature review and expert judgement to identify the most important site selection criteria. A two-step site selection process was used. Candidate sites were chosen that meet a subset of the selection criteria that form the most important system constraints. These candidate sites were then evaluated against the full set of selection criteria using the Analytical Hierarchy Process Method (AHP). Candidate sites underwent a set of more specific siting criteria weighted by expert judgment to select preferable sites and alternatives using AHP method again. Expert Judgment method was used to rank and weight the importance of each criteria, then AHP method used to evaluate and weight the relation between criterion to criterion and between all criteria against the global weight. Then logical decision software was used to rank sites upon their weighting value

A Study on Alternative Approaches to Instill Environmental Concerns in the Domain of Production Management of Industrial Firms

Directory of Open Access Journals (Sweden)

Ronaldo Manzan

2013-10-01

Full Text Available This article presents a comparative analysis of alternative models of production with environmental concerns that may lead to higher effectiveness in initiatives undertaken by industrial firms towards the development of more sustainable operations. The objective is to organize the knowledge on the subject of such models and provide guidelines that may help managers in selecting the most fitting approach for their business, according to the strategy and conditions of the firm. Among the presented models, the Cleaner Production model stands out for promoting the approach of nurturing the concurrent strengthening of quality, productivity, and sustainability in the existing manufacturing processes by dealing more comprehensively with factors internal to the firm that may be directly controlled by the managers.

An alternative surgical approach for the combined treatment of pectus excavatum and acute aortic dissection type-A in Marfan syndrome.

Science.gov (United States)

Schwill, Simon; Kallenbach, Klaus; Beller, Carsten J; Karck, Matthias

2011-04-01

Acute aortic dissection type-A (AADA) is a life-threatening condition especially in patients with Marfan syndrome (MFS) simultaneously suffering from severe pectus excavatum (PE). We report on emergency surgery for combined treatment of PE and AADA in a patient with MFS using an alternative approach. It leads to excellent exposure of the dislocated heart and great vessels enabling Bentall procedure followed by funnel chest repair with modified technique of Adkins and Blades. We achieved favorable functional and cosmetic results. Therefore, we conclude the surgical approach presented is feasible for standard treatment of AADA and consecutive repair of PE.

Nonpharmacologic treatment of functional abdominal pain disorders: a systematic review.

Science.gov (United States)

Rutten, Juliette M T M; Korterink, Judith J; Venmans, Leonie M A J; Benninga, Marc A; Tabbers, Merit M

2015-03-01

Various nonpharmacologic treatments are available for pediatric abdominal pain-related functional gastrointestinal disorders (AP-FGIDs). Data on efficacy and safety are scarce. The goal of this study was to summarize the evidence regarding nonpharmacologic interventions for pediatric AP-FGIDs: lifestyle interventions, dietary interventions, behavioral interventions, prebiotics and probiotics, and alternative medicine. Searches were conducted of the Medline and Cochrane Library databases. Systematic reviews and randomized controlled trials (RCTs) concerning nonpharmacologic therapies in children (aged 3-18 years) with AP-FGIDs were included, and data were extracted on participants, interventions, and outcomes. The quality of evidence was assessed by using the GRADE approach. Twenty-four RCTs were found that included 1390 children. Significant improvement of abdominal pain was reported after hypnotherapy compared with standard care/wait-list approaches and after cognitive behavioral therapy compared with a variety of control treatments/wait-list approaches. Written self-disclosure improved pain frequency at the 6-month follow-up only. Compared with placebo, Lactobacillus rhamnosus GG (LGG) and VSL#3 were associated with significantly more treatment responders (LGG relative risk: 1.31 [95% confidence interval: 1.08 to 1.59]; VSL#3: P pediatric AP-FGIDs. Data on fiber supplements are inconclusive. Copyright © 2015 by the American Academy of Pediatrics.

Quality assurance in proton therapy: a systematic approach in progress at Orsay

International Nuclear Information System (INIS)

Mazal, A.; Habrand, J.L.; Laforture, F.; Breteau, N.; Mazal, A.; Habrand, J.L.; Breteau, N.

1996-01-01

The degree of accuracy and reliability required in proton therapy can only be guaranteed of a comprehensive quality assurance (QA) programme is established. Such a programme obviously has common features with general QA in radiotherapy, but some aspects are specific to the use of protons and particularly to the characteristics of each facility. A study is in progress at Orsay to convert a series of quality controls into a systematic quality assurance programme. It includes some basic steps on organisation, setting up a QA committee and QA task groups, organizing meetings, policies, procedures, records qualifications, and determining some examples of tolerance in controls. Among some critical and specific points identified in this process are the combined treatment with photons at different institutions, the specificity of a non-hospital and complex facility, the high degree of precision required for the patient setup, and the need to develop in-house basic tools such as the treatment planning system. The inclusion of all the patients in prospective well-defined clinical trials, the comparison with alternative techniques and the radiobiological studies are considered as fundamentals for the QA programme. Present dosimetric and radiobiological intercomparisons between proton-therapy centres are considered as partial audits. A study is in progress to establish common dosimetric and clinical protocols, radiological models and dose and volume specifications. In spite of the differences between the existing facilities, it should be possible to obtain international consensus on general guidelines for a QA programme in proton therapy. (author)

MuSiC: a Multibunch and multiparticle Simulation Code with an alternative approach to wakefield effects

CERN Document Server

Migliorati, M

2015-01-01

The simulation of beam dynamics in presence of collective effects requires a strong computational effort to take into account, in a self consistent way, the wakefield acting on a given charge and produced by all the others. Generally this is done by means of a convolution integral or sum. Moreover, if the electromagnetic fields consist of resonant modes with high quality factors, responsible, for example, of coupled bunch instabilities, a charge is also affected by itself in previous turns, and a very long record of wakefield must be properly taken into account. In this paper we present a new simulation code for the longitudinal beam dynamics in a circular accelerator, which exploits an alternative approach to the currently used convolution sum, reducing the computing time and avoiding the issues related to the length of wakefield for coupled bunch instabilities. With this approach it is possible to simulate, without the need of a large computing power, simultaneously, the single and multi-bunch beam dynamics...

A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy.

Science.gov (United States)

Close, Ciara; Sinclair, Marlene; Liddle, S Dianne; Madden, Elaine; McCullough, Julie E M; Hughes, Ciara

2014-08-01

To evaluate and summarize the current evidence on the effectiveness of complementary and alternative medicine for the management of low back pain and/or pelvic pain in pregnancy. International research demonstrates that 25-30% of women use complementary and alternative medicine to manage low back and pelvic pain in pregnancy without robust evidence demonstrating its effectiveness. A systematic review of randomized controlled trials to determine the effectiveness of complementary and alternative medicine for low back and/or pelvic pain in pregnancy. Cochrane library (1898-2013), PubMed (1996-2013), MEDLINE (1946-2013), AMED (1985-2013), Embase (1974-2013), Cinahl (1937-2013), Index to Thesis (1716-2013) and Ethos (1914-2013). Selected studies were written in English, randomized controlled trials, a group 1 or 2 therapy and reported pain reduction as an outcome measure. Study quality was reviewed using Risk of Bias and evidence strength the Cochrane Grading of Recommendations and Development Evaluation Tool. Eight studies were selected for full review. Two acupuncture studies with low risk of bias showed both clinically important changes and statistically significant results. There was evidence of effectiveness for osteopathy and chiropractic. However, osteopathy and chiropractic studies scored high for risk of bias. Strength of the evidence across studies was very low. There is limited evidence supporting the use of general CAM for managing pregnancy-related low back and/or pelvic pain. However, the restricted availability of high-quality studies, combined with the very low evidence strength, makes it impossible to make evidence-based recommendations for practice. © 2014 John Wiley & Sons Ltd.

Functional vs. Traditional Analysis in Biomechanical Gait Data: An Alternative Statistical Approach.

Science.gov (United States)

Park, Jihong; Seeley, Matthew K; Francom, Devin; Reese, C Shane; Hopkins, J Ty

2017-12-01

In human motion studies, discrete points such as peak or average kinematic values are commonly selected to test hypotheses. The purpose of this study was to describe a functional data analysis and describe the advantages of using functional data analyses when compared with a traditional analysis of variance (ANOVA) approach. Nineteen healthy participants (age: 22 ± 2 yrs, body height: 1.7 ± 0.1 m, body mass: 73 ± 16 kg) walked under two different conditions: control and pain+effusion. Pain+effusion was induced by injection of sterile saline into the joint capsule and hypertonic saline into the infrapatellar fat pad. Sagittal-plane ankle, knee, and hip joint kinematics were recorded and compared following injections using 2×2 mixed model ANOVAs and FANOVAs. The results of ANOVAs detected a condition × time interaction for the peak ankle (F1,18 = 8.56, p = 0.01) and hip joint angle (F1,18 = 5.77, p = 0.03), but did not for the knee joint angle (F1,18 = 0.36, p = 0.56). The functional data analysis, however, found several differences at initial contact (ankle and knee joint), in the mid-stance (each joint) and at toe off (ankle). Although a traditional ANOVA is often appropriate for discrete or summary data, in biomechanical applications, the functional data analysis could be a beneficial alternative. When using the functional data analysis approach, a researcher can (1) evaluate the entire data as a function, and (2) detect the location and magnitude of differences within the evaluated function.

Functional vs. Traditional Analysis in Biomechanical Gait Data: An Alternative Statistical Approach

Directory of Open Access Journals (Sweden)

Park Jihong

2017-12-01

Full Text Available In human motion studies, discrete points such as peak or average kinematic values are commonly selected to test hypotheses. The purpose of this study was to describe a functional data analysis and describe the advantages of using functional data analyses when compared with a traditional analysis of variance (ANOVA approach. Nineteen healthy participants (age: 22 ± 2 yrs, body height: 1.7 ± 0.1 m, body mass: 73 ± 16 kg walked under two different conditions: control and pain+effusion. Pain+effusion was induced by injection of sterile saline into the joint capsule and hypertonic saline into the infrapatellar fat pad. Sagittal-plane ankle, knee, and hip joint kinematics were recorded and compared following injections using 2×2 mixed model ANOVAs and FANOVAs. The results of ANOVAs detected a condition × time interaction for the peak ankle (F1,18 = 8.56, p = 0.01 and hip joint angle (F1,18 = 5.77, p = 0.03, but did not for the knee joint angle (F1,18 = 0.36, p = 0.56. The functional data analysis, however, found several differences at initial contact (ankle and knee joint, in the mid-stance (each joint and at toe off (ankle. Although a traditional ANOVA is often appropriate for discrete or summary data, in biomechanical applications, the functional data analysis could be a beneficial alternative. When using the functional data analysis approach, a researcher can (1 evaluate the entire data as a function, and (2 detect the location and magnitude of differences within the evaluated function.

Clinical outcomes with alternative dosing strategies for piperacillin/tazobactam: a systematic review and meta-analysis.

Directory of Open Access Journals (Sweden)

Hui Yang

Full Text Available A better dosing strategy can improve clinical outcomes for patients. We sought to compare the extended or continuous infusion with conventional intermittent infusion of piperacillin/tazobactam, investigating which approach is better and worthy of recommendation for clinical use.Articles were gathered from PubMed, Web of Science, ProQuest, Science Direct, Cochrane, two Chinese literature databases (CNKI, Wan Fang Data and related ICAAC and ACCP conferences. Randomized controlled and observational studies that compared extended or continuous infusion with conventional intermittent infusion of piperacillin/tazobactam were identified from the databases above and analyzed. Two reviewers independently extracted and investigated the data. A meta-analysis was performed using Revman 5.2 software. The quality of each study was assessed. Sensitivity analysis and publication bias were evaluated.Five randomized controlled trials and nine observational studies were included in this study. All included studies had high quality and no publication bias was found. Compared to the conventional intermittent infusion approach, the extended or continuous infusion group had a significantly higher clinical cure rate (OR 1.88, 95% CI 1.29-2.73, P = 0.0009 and a lower mortality rate (OR 0.67, 95% CI 0.50-0.89, P = 0.005. No statistical difference was observed for bacteriologic cure (OR 1.40, 95% CI 0.82-2.37, P = 0.22 between the two dosing regimens. The sensitivity analysis showed the results were stable.Our systematic review and meta-analysis suggested that the extended or continuous infusion strategy of piperacillin/tazobactam should be recommended for clinical use considering its higher clinical cure rate and lower mortality rate in comparison with conventional intermittent strategy. Data from this study could be extrapolated for other β-lactam antimicrobials. Therefore, this dosing strategy could be considered in clinical practice.

Systematic Review Workshop (August 2013)

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The goal for this workshop is to receive scientific input regarding approaches for different steps within a systematic review, such as evaluating individual studies, synthesizing evidence within a particular discipline, etc.

Baryon density in alternative BBN models

International Nuclear Information System (INIS)

Kirilova, D.

2002-10-01

We present recent determinations of the cosmological baryon density ρ b , extracted from different kinds of observational data. The baryon density range is not very wide and is usually interpreted as an indication for consistency. It is interesting to note that all other determinations give higher baryon density than the standard big bang nucleosynthesis (BBN) model. The differences of the ρ b values from the BBN predicted one (the most precise today) may be due to the statistical and systematic errors in observations. However, they may be an indication of new physics. Hence, it is interesting to study alternative BBN models, and the possibility to resolve the discrepancies. We discuss alternative cosmological scenarios: a BBN model with decaying particles (m ∼ MeV, τ ∼ sec) and BBN with electron-sterile neutrino oscillations, which permit to relax BBN constraints on the baryon content of the Universe. (author)

Systematic Review of Differential Reinforcement of Alternative Behavior Without Extinction for Individuals With Autism.

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MacNaul, Hannah L; Neely, Leslie C

2018-05-01

The purpose of this article is to review the literature on differential reinforcement of alternative behavior procedures without extinction for individuals with autism. Using predetermined inclusion criteria, a total of 10 studies were included and summarized in terms of the following: (a) participant characteristics (e.g., sex, age, and diagnosis), (b) treatment setting, (c) problem behavior, (d) function, (e) alternative behavior, (f) intervention, (g) outcomes, and (h) conclusiveness of evidence. Of the 10 studies, nine demonstrated positive effects and one mixed effects. Five studies successfully reduced problem behavior by manipulating different reinforcement parameters (magnitude, immediacy, and quality) and four manipulated the schedule of reinforcement. One study had mixed results with two of the three participants requiring extinction. The findings of this review suggest that variations of differential reinforcement of alternative behavior interventions without an extinction component may be considered promising practices for the treatment of challenging behavior in individuals with autism.

Management of spent oxide fuel from thermal reactors: the environmental and radiological effects of alternative approaches

International Nuclear Information System (INIS)

Martin, A.; Fry, T.M.; Edmunds, J.

1983-07-01

The report presents the results of a study of the environmental and radiological effects of alternative approaches to the management of spent oxide fuel from the UK nuclear power programme. The two main alternatives are extended storage of the fuel, pending decisions on fissile material recycle, and reprocessing of the fuel commencing in the early 1990s. A review is made of experience in spent fuel storage, of the technical issues in long-term storage and of the possible needs of the UK nuclear programme. The main environmental and radiological effects of reprocessing considered in the study are the generation of radioactive wastes, the release of radioactivity in effluents with the resulting radiation exposure of the public, and occupational radiation exposure. The influence of the delay between reprocessing and fabrication of mixed oxide fuel on the environmental and radiological effects of plutonium recycle is investigated and it is shown that the effects would be minimised if reprocessing were delayed until there was a requirement for recycle. Strategies for the management of heavy elements other than plutonium are discussed and results are presented illustrating aspects of actinide management. (author)

A systematic approach to robust preconditioning for gradient-based inverse scattering algorithms

International Nuclear Information System (INIS)

Nordebo, Sven; Fhager, Andreas; Persson, Mikael; Gustafsson, Mats

2008-01-01

This paper presents a systematic approach to robust preconditioning for gradient-based nonlinear inverse scattering algorithms. In particular, one- and two-dimensional inverse problems are considered where the permittivity and conductivity profiles are unknown and the input data consist of the scattered field over a certain bandwidth. A time-domain least-squares formulation is employed and the inversion algorithm is based on a conjugate gradient or quasi-Newton algorithm together with an FDTD-electromagnetic solver. A Fisher information analysis is used to estimate the Hessian of the error functional. A robust preconditioner is then obtained by incorporating a parameter scaling such that the scaled Fisher information has a unit diagonal. By improving the conditioning of the Hessian, the convergence rate of the conjugate gradient or quasi-Newton methods are improved. The preconditioner is robust in the sense that the scaling, i.e. the diagonal Fisher information, is virtually invariant to the numerical resolution and the discretization model that is employed. Numerical examples of image reconstruction are included to illustrate the efficiency of the proposed technique

The difficulties of systematic reviews.

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Westgate, Martin J; Lindenmayer, David B

2017-10-01

The need for robust evidence to support conservation actions has driven the adoption of systematic approaches to research synthesis in ecology. However, applying systematic review to complex or open questions remains challenging, and this task is becoming more difficult as the quantity of scientific literature increases. We drew on the science of linguistics for guidance as to why the process of identifying and sorting information during systematic review remains so labor intensive, and to provide potential solutions. Several linguistic properties of peer-reviewed corpora-including nonrandom selection of review topics, small-world properties of semantic networks, and spatiotemporal variation in word meaning-greatly increase the effort needed to complete the systematic review process. Conversely, the resolution of these semantic complexities is a common motivation for narrative reviews, but this process is rarely enacted with the rigor applied during linguistic analysis. Therefore, linguistics provides a unifying framework for understanding some key challenges of systematic review and highlights 2 useful directions for future research. First, in cases where semantic complexity generates barriers to synthesis, ecologists should consider drawing on existing methods-such as natural language processing or the construction of research thesauri and ontologies-that provide tools for mapping and resolving that complexity. These tools could help individual researchers classify research material in a more robust manner and provide valuable guidance for future researchers on that topic. Second, a linguistic perspective highlights that scientific writing is a rich resource worthy of detailed study, an observation that can sometimes be lost during the search for data during systematic review or meta-analysis. For example, mapping semantic networks can reveal redundancy and complementarity among scientific concepts, leading to new insights and research questions. Consequently

Evaluation of simulation alternatives for the brute-force ray-tracing approach used in backlight design

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Desnijder, Karel; Hanselaer, Peter; Meuret, Youri

2016-04-01

A key requirement to obtain a uniform luminance for a side-lit LED backlight is the optimised spatial pattern of structures on the light guide that extract the light. The generation of such a scatter pattern is usually performed by applying an iterative approach. In each iteration, the luminance distribution of the backlight with a particular scatter pattern is analysed. This is typically performed with a brute-force ray-tracing algorithm, although this approach results in a time-consuming optimisation process. In this study, the Adding-Doubling method is explored as an alternative way for evaluating the luminance of a backlight. Due to the similarities between light propagating in a backlight with extraction structures and light scattering in a cloud of light scatterers, the Adding-Doubling method which is used to model the latter could also be used to model the light distribution in a backlight. The backlight problem is translated to a form upon which the Adding-Doubling method is directly applicable. The calculated luminance for a simple uniform extraction pattern with the Adding-Doubling method matches the luminance generated by a commercial raytracer very well. Although successful, no clear computational advantage over ray tracers is realised. However, the dynamics of light propagation in a light guide as used the Adding-Doubling method, also allow to enhance the efficiency of brute-force ray-tracing algorithms. The performance of this enhanced ray-tracing approach for the simulation of backlights is also evaluated against a typical brute-force ray-tracing approach.

AN ALTERNATIVE APPROACH TO MEET BEEF SELF-SUFFICIENCY IN WEST PAPUA

Directory of Open Access Journals (Sweden)

S. Hartono

2011-09-01

Full Text Available The main objective of this research is to present an alternative approach to meet beef self-sufficiency in West Papua, Indonesia. It mainly focuses on calculating the needed number of productive cows to enhance beef production in the province. Out of the total farmer households in Manokwari, Indonesia, 189 farmer-respondents were selected as samples of the study. Selection of the sample was based on the number of cattle kept in every age group (less than one (2 years old and the number of productive cows. Secondary data came from the time series data of the number of slaughtered cattle vis-à-vis the population of all districts in West Papua Province from 1980-2008. Data were analyzed using the Partial Adjustment Model (PAM and Ordinary Least Square (OLS method. Results of the study showed that beef self-sufficiency in West Papua depend on the availability of the number of productive cows to produce ready-slaughtered-bull in the previous year. Particularly for West Papua, to produce one unit of bull in the tth –year, with the assumption that cattle mortality is 4.92%, a number of 2.38 animal units AU of productive cows must be provided in the previous two (2 years.

Alternatives to relational databases in precision medicine: Comparison of NoSQL approaches for big data storage using supercomputers

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Velazquez, Enrique Israel

Improvements in medical and genomic technologies have dramatically increased the production of electronic data over the last decade. As a result, data management is rapidly becoming a major determinant, and urgent challenge, for the development of Precision Medicine. Although successful data management is achievable using Relational Database Management Systems (RDBMS), exponential data growth is a significant contributor to failure scenarios. Growing amounts of data can also be observed in other sectors, such as economics and business, which, together with the previous facts, suggests that alternate database approaches (NoSQL) may soon be required for efficient storage and management of big databases. However, this hypothesis has been difficult to test in the Precision Medicine field since alternate database architectures are complex to assess and means to integrate heterogeneous electronic health records (EHR) with dynamic genomic data are not easily available. In this dissertation, we present a novel set of experiments for identifying NoSQL database approaches that enable effective data storage and management in Precision Medicine using patients' clinical and genomic information from the cancer genome atlas (TCGA). The first experiment draws on performance and scalability from biologically meaningful queries with differing complexity and database sizes. The second experiment measures performance and scalability in database updates without schema changes. The third experiment assesses performance and scalability in database updates with schema modifications due dynamic data. We have identified two NoSQL approach, based on Cassandra and Redis, which seems to be the ideal database management systems for our precision medicine queries in terms of performance and scalability. We present NoSQL approaches and show how they can be used to manage clinical and genomic big data. Our research is relevant to the public health since we are focusing on one of the main

77 FR 36423 - Labeling Requirements for Alternative Fuels and Alternative Fueled Vehicles

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2012-06-19

... delivered to the following address: Federal Trade Commission, Office of the Secretary, Room H-113 (Annex N... cell, advanced lean burn, and hybrid motor vehicles) that were added to the definition of ``alternative... legislation (i.e., lean burn, hybrid, and fuel cell vehicles). No comments opposed this approach. Edison...

Alternative Measuring Approaches in Gamma Scanning on Spent Nuclear Fuel

Energy Technology Data Exchange (ETDEWEB)

Sihm Kvenangen, Karen

2007-06-15

In the future, the demand for energy is predicted to grow and more countries plan to utilize nuclear energy as their source of electric energy. This gives rise to many important issues connected to nuclear energy, such as finding methods that can verify that the spent nuclear fuel has been handled safely and used in ordinary power producing cycles as stated by the operators. Gamma ray spectroscopy is one method used for identification and verification of spent nuclear fuel. In the specific gamma ray spectroscopy method called gamma scanning the gamma radiation from the fission products Cs-137, Cs-134 and Eu-154 are measured in a spent fuel assembly. From the results, conclusions can be drawn about the fuels characteristics. This degree project examines the possibilities of using alternative measuring approaches when using the gamma scanning method. The focus is on examining how to increase the quality of the measured data. How to decrease the measuring time as compared with the present measuring strategy, has also been investigated. The main part of the study comprises computer simulations of gamma scanning measurements. The simulations have been validated with actual measurements on spent nuclear fuel at the central interim storage, Clab. The results show that concerning the quality of the measuring data the conventional strategy is preferable, but with other starting positions and with a more optimized equipment. When focusing on the time aspect, the helical measuring strategy can be an option, but this needs further investigation.

Alternative Measuring Approaches in Gamma Scanning on Spent Nuclear Fuel

International Nuclear Information System (INIS)

Sihm Kvenangen, Karen

2007-06-01

In the future, the demand for energy is predicted to grow and more countries plan to utilize nuclear energy as their source of electric energy. This gives rise to many important issues connected to nuclear energy, such as finding methods that can verify that the spent nuclear fuel has been handled safely and used in ordinary power producing cycles as stated by the operators. Gamma ray spectroscopy is one method used for identification and verification of spent nuclear fuel. In the specific gamma ray spectroscopy method called gamma scanning the gamma radiation from the fission products Cs-137, Cs-134 and Eu-154 are measured in a spent fuel assembly. From the results, conclusions can be drawn about the fuels characteristics. This degree project examines the possibilities of using alternative measuring approaches when using the gamma scanning method. The focus is on examining how to increase the quality of the measured data. How to decrease the measuring time as compared with the present measuring strategy, has also been investigated. The main part of the study comprises computer simulations of gamma scanning measurements. The simulations have been validated with actual measurements on spent nuclear fuel at the central interim storage, Clab. The results show that concerning the quality of the measuring data the conventional strategy is preferable, but with other starting positions and with a more optimized equipment. When focusing on the time aspect, the helical measuring strategy can be an option, but this needs further investigation

Alternative approaches for vertebrate ecotoxicity tests in the 21st century: A review of developments over the last 2 decades and current status

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The need for alternative approaches to the use of vertebrate animals for hazard assessing chemicals and pollutants has become of increasing importance. It is now the first consideration when initiating a vertebrate ecotoxicity test, to ensure that unnecessary use of vertebrate or...

An Alternative Methodological Approach for Cost-Effectiveness Analysis and Decision Making in Genomic Medicine.

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Fragoulakis, Vasilios; Mitropoulou, Christina; van Schaik, Ron H; Maniadakis, Nikolaos; Patrinos, George P

2016-05-01

Genomic Medicine aims to improve therapeutic interventions and diagnostics, the quality of life of patients, but also to rationalize healthcare costs. To reach this goal, careful assessment and identification of evidence gaps for public health genomics priorities are required so that a more efficient healthcare environment is created. Here, we propose a public health genomics-driven approach to adjust the classical healthcare decision making process with an alternative methodological approach of cost-effectiveness analysis, which is particularly helpful for genomic medicine interventions. By combining classical cost-effectiveness analysis with budget constraints, social preferences, and patient ethics, we demonstrate the application of this model, the Genome Economics Model (GEM), based on a previously reported genome-guided intervention from a developing country environment. The model and the attendant rationale provide a practical guide by which all major healthcare stakeholders could ensure the sustainability of funding for genome-guided interventions, their adoption and coverage by health insurance funds, and prioritization of Genomic Medicine research, development, and innovation, given the restriction of budgets, particularly in developing countries and low-income healthcare settings in developed countries. The implications of the GEM for the policy makers interested in Genomic Medicine and new health technology and innovation assessment are also discussed.

Evaluating clinical librarian services: a systematic review.

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Brettle, Alison; Maden-Jenkins, Michelle; Anderson, Lucy; McNally, Rosalind; Pratchett, Tracey; Tancock, Jenny; Thornton, Debra; Webb, Anne

2011-03-01

  Previous systematic reviews have indicated limited evidence and poor quality evaluations of clinical librarian (CL) services. Rigorous evaluations should demonstrate the value of CL services, but guidance is needed before this can be achieved.   To undertake a systematic review which examines models of CL services, quality, methods and perspectives of clinical librarian service evaluations.   Systematic review methodology and synthesis of evidence, undertaken collaboratively by a group of 8 librarians to develop research and critical appraisal skills.   There are four clear models of clinical library service provision. Clinical librarians are effective in saving health professionals time, providing relevant, useful information and high quality services. Clinical librarians have a positive effect on clinical decision making by contributing to better informed decisions, diagnosis and choice of drug or therapy. The quality of CL studies is improving, but more work is needed on reducing bias and providing evidence of specific impacts on patient care. The Critical Incident Technique as part of a mixed method approach appears to offer a useful approach to demonstrating impact.   This systematic review provides practical guidance regarding the evaluation of CL services. It also provides updated evidence regarding the effectiveness and impact of CL services. The approach used was successful in developing research and critical appraisal skills in a group of librarians. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

A Systematic Identification of Scientists on Twitter

Energy Technology Data Exchange (ETDEWEB)

Ke, Q.; Ahn, Y.Y.; Sugimoto, C.R.

2016-07-01

There is an increasing use of Twitter and other social media to estimate the broader social impacts of scholarship. However, without systematic understanding of the entities that participate in conversations about science, efforts to translate altmetrics into impact indicators may produce highly misleading results. Here we present a systematic approach to identifying scientists on Twitter. (Author)

Energy Efficient Alternatives to Chlorofluorocarbons (CFCs)

Energy Technology Data Exchange (ETDEWEB)

None

1993-06-01

An assessment of the state of the art in refrigeration and insulation technologies is carried out to evaluate the potential for efficient substitutes for CFCs and HCFCs to facilitate the transition to a CFC-free environment. Opportunities for improved efficiency in domestic refrigeration, building chillers, commercial refrigeration and industrial refrigeration are evaluated. Needs for alternate refrigerants, improved components, and/or alternate cycles are identified. A summary of on-going research is presented in each area, and the potential roles of industry and government are considered. The most promising approaches for refrigeration technology fall into these categories: (1) improved vapor compressor cycles with alternate fluids, (2) Stirling cycle development and (3) advances in absorption technology. A summary of on-going research into advanced insulation, focused on vacuum-based insulation technology refrigeration is developed. Insulation applications considered include appliances, transport refrigeration, and buildings. Specific recommendations for a long-term R&D agenda are presented. The potential benefits, research, general approach, and probability of success are addressed.

Systematic study of source mask optimization and verification flows

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Ben, Yu; Latypov, Azat; Chua, Gek Soon; Zou, Yi

2012-06-01

Source mask optimization (SMO) emerged as powerful resolution enhancement technique (RET) for advanced technology nodes. However, there is a plethora of flow and verification metrics in the field, confounding the end user of the technique. Systemic study of different flows and the possible unification thereof is missing. This contribution is intended to reveal the pros and cons of different SMO approaches and verification metrics, understand the commonality and difference, and provide a generic guideline for RET selection via SMO. The paper discusses 3 different type of variations commonly arise in SMO, namely pattern preparation & selection, availability of relevant OPC recipe for freeform source and finally the metrics used in source verification. Several pattern selection algorithms are compared and advantages of systematic pattern selection algorithms are discussed. In the absence of a full resist model for SMO, alternative SMO flow without full resist model is reviewed. Preferred verification flow with quality metrics of DOF and MEEF is examined.

A systematic checklist approach to immunosuppression risk management: An audit of practice at two clinical neuroimmunology centers.

Science.gov (United States)

Mori, Amelia M; Agarwal, Smriti; Lee, Monique W M; Rafferty, Martina; Hardy, Todd A; Coles, Alasdair; Reddel, Stephen W; Riminton, D Sean

2017-11-15

There is no consensus approach to safety screening for immune intervention in clinical neuroimmunology. An immunosuppression risk evaluation checklist was used as an audit tool to assess real-world immunosuppression risk management and formulate recommendations for quality improvements in patient safety. Ninety-nine patients from two centres with 27 non-MS diagnoses were included. An average of 1.9 comorbidities with the potential to adversely impact morbidity and mortality associated with immunosuppression were identified. Diabetes and smoking were the most common, however a range of rarer but potentially life-threatening co-morbid disorders in the context of immunosuppression were identified. Inadequate documentation of risk mitigation tasks was common at 40.1% of total tasks across both cohorts. A routine, systematic immunosuppression checklist approach should be considered to improve immunosuppression risk management in clinical neuroimmunology practice. Copyright © 2017 Elsevier B.V. All rights reserved.

Comparison of marine spatial planning methods in Madagascar demonstrates value of alternative approaches.

Directory of Open Access Journals (Sweden)

Thomas F Allnutt

Full Text Available The Government of Madagascar plans to increase marine protected area coverage by over one million hectares. To assist this process, we compare four methods for marine spatial planning of Madagascar's west coast. Input data for each method was drawn from the same variables: fishing pressure, exposure to climate change, and biodiversity (habitats, species distributions, biological richness, and biodiversity value. The first method compares visual color classifications of primary variables, the second uses binary combinations of these variables to produce a categorical classification of management actions, the third is a target-based optimization using Marxan, and the fourth is conservation ranking with Zonation. We present results from each method, and compare the latter three approaches for spatial coverage, biodiversity representation, fishing cost and persistence probability. All results included large areas in the north, central, and southern parts of western Madagascar. Achieving 30% representation targets with Marxan required twice the fish catch loss than the categorical method. The categorical classification and Zonation do not consider targets for conservation features. However, when we reduced Marxan targets to 16.3%, matching the representation level of the "strict protection" class of the categorical result, the methods show similar catch losses. The management category portfolio has complete coverage, and presents several management recommendations including strict protection. Zonation produces rapid conservation rankings across large, diverse datasets. Marxan is useful for identifying strict protected areas that meet representation targets, and minimize exposure probabilities for conservation features at low economic cost. We show that methods based on Zonation and a simple combination of variables can produce results comparable to Marxan for species representation and catch losses, demonstrating the value of comparing alternative

A systematic review of outcomes of chronic disease self-management interventions.

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Nolte, Sandra; Osborne, Richard H

2013-09-01

To carry out a systematic review of program outcomes used in the evaluation of group-based self-management interventions aimed at people with arthritis and other chronic conditions. The systematic search was performed across databases MEDLINE, EMBASE, CINAHL, and PsycINFO. Both between-group and within-group effect sizes (ES) were calculated. Results were interpreted as small (ES ~ 0.2), medium (ES ~ 0.5), or large (ES ~ 0.8) effects. The majority of 18 included trials investigated the effectiveness of arthritis-specific interventions. Across most outcomes, small effects on course participants were shown. While effects on knowledge were large (between-group ES = 0.78), effects on clinical outcomes such as pain (ES = 0.10) were negligible to small. This paper is consistent with other reviews in this area, suggesting that people with arthritis receive only marginal benefits from participating in chronic disease self-management interventions. When looking at the types of outcomes that trials are based on, however, alternative explanations for these results seem probable. As evaluations heavily rely on patient self-report, current approaches to program evaluation may not be sufficient to assess the intended impact of self-management education. An in-depth investigation of the types of outcomes assessed is provided in a separate paper.

Living systematic reviews: 2. Combining human and machine effort.

Science.gov (United States)

Thomas, James; Noel-Storr, Anna; Marshall, Iain; Wallace, Byron; McDonald, Steven; Mavergames, Chris; Glasziou, Paul; Shemilt, Ian; Synnot, Anneliese; Turner, Tari; Elliott, Julian

2017-11-01

New approaches to evidence synthesis, which use human effort and machine automation in mutually reinforcing ways, can enhance the feasibility and sustainability of living systematic reviews. Human effort is a scarce and valuable resource, required when automation is impossible or undesirable, and includes contributions from online communities ("crowds") as well as more conventional contributions from review authors and information specialists. Automation can assist with some systematic review tasks, including searching, eligibility assessment, identification and retrieval of full-text reports, extraction of data, and risk of bias assessment. Workflows can be developed in which human effort and machine automation can each enable the other to operate in more effective and efficient ways, offering substantial enhancement to the productivity of systematic reviews. This paper describes and discusses the potential-and limitations-of new ways of undertaking specific tasks in living systematic reviews, identifying areas where these human/machine "technologies" are already in use, and where further research and development is needed. While the context is living systematic reviews, many of these enabling technologies apply equally to standard approaches to systematic reviewing. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

An alternative approach to KP hierarchy in matrix models

International Nuclear Information System (INIS)

Bonora, L.; Xiong, C.S.

1992-01-01

We show that there exists an alternative procedure in order to extract differential hierarchies, such as the KdV hierarchy, from one-matrix models, without taking a continuum limit. To prove this we introduce the Toda lattice and reformulate it in operator form. We then consider the reduction to the systems appropriate for a one-matrix model. (orig.)

The graded approach to SAT: A cost effective use of the systematic approach to training

International Nuclear Information System (INIS)

Coe, R.P.; Bruno, R.J.